Individual
MRS. THERESSA ROSE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, CRC
Contact information
Practice address
1310 W MAIN ST, RUSSELLVILLE, AR 72801-2816
(870) 647-1400
Mailing address
1310 W MAIN ST, RUSSELLVILLE, AR 72801-2816
(870) 647-1400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A1407092
AR
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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