Individual
TINA W EMBRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
625 CLIFTON ST, CAMDEN, AR 71701-3327
(870) 836-9362
(870) 836-9363
Mailing address
625 CLIFTON ST, CAMDEN, AR 71701-3327
(870) 836-9362
(870) 836-9363
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0207029
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302413
MHN NETWORK NUMBER
AR
01
—
5W957
BLUE CROSS AND BLUE SHIEL
AR
Enumeration date
01/30/2006
Last updated
12/02/2019
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