Organization
YOUTH BRIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY LOTT (PROGRAM DIRECTOR)
(479) 521-1532
Entity
Organization
Contact information
Practice address
2153 EAST JOYCE BOULEVARD, FAYETTEVILLE, AR 72703
(479) 521-1532
Mailing address
2153 EAST JOYCE BOULEVARD, FAYETTEVILLE, AR 72703
(479) 521-1532
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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