Individual
TAMMY TRIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3201 W KEISER AVE, OSCEOLA, AR 72370-3467
(870) 622-0592
(870) 622-0782
Mailing address
1815 PLEASANT GROVE RD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
5949-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187841795
—
AR
Enumeration date
08/09/2011
Last updated
05/14/2018
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