Individual
MS. EBONE LA QUESA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6210 BASELINE RD, LITTLE ROCK, AR 72209-4728
(501) 265-0302
(501) 265-0300
Mailing address
6210 BASELINE RD, LITTLE ROCK, AR 72209-4728
(501) 265-0302
(501) 265-0300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7590-M
AR
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236900526
—
AR
Enumeration date
06/18/2014
Last updated
05/17/2021
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