Individual
THEO STEPHEN GAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1815 PLEASANT GROVE RD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395
Mailing address
1815 PLEASANT GROVE ROAD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P2405002
AR
171M00000X
Case Manager/Care Coordinator
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237117795
—
AR
Enumeration date
06/08/2017
Last updated
05/15/2024
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