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Individual

MS. HOLLY G LAVALLE-ROUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHPP

Contact information

Practice address
4081 HIGHWAY 7 S, HARRISON, AR 72601-5047
(866) 308-9925
Mailing address
516 S WALNUT ST, HARRISON, AR 72601-5249
(870) 204-1136

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
12/29/2011
Last updated
12/29/2011
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