Organization
DAILY BREAD COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARRY DEAN TEETER LPC (OWNER)
(501) 847-2229
Entity
Organization
Contact information
Practice address
200 N MARKET ST, BENTON, AR 72015-3733
(501) 847-2229
(501) 847-8608
Mailing address
PO BOX 298, BRYANT, AR 72089-0298
(501) 847-2229
(501) 847-8608
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P9903009
AR
102L00000X
Psychoanalyst
P9903009
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142495019
—
AR
Enumeration date
09/17/2009
Last updated
09/17/2009
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