Individual
ROGER CAMERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACADC, CCS
Contact information
Practice address
2304 W 29TH AVE, SUITE 1, PINE BLUFF, AR 71603-5005
(870) 247-5222
(870) 671-4847
Mailing address
PO BOX 21203, WHITE HALL, AR 71612-1203
(870) 247-5222
(870) 671-4847
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A-100
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206619740
—
AR
Enumeration date
03/25/2015
Last updated
03/25/2015
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