Individual
JESSICA WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSE
Contact information
Practice address
221 LINDLEY LN, NEWPORT, AR 72112-4954
(870) 523-2124
Mailing address
1840 BLACKLAND RD, OIL TROUGH, AR 72564-9750
(870) 799-9013
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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