Individual
JESSICA IMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34 W COLT SQUARE DR STE 3, FAYETTEVILLE, AR 72703-2888
(479) 595-0333
Mailing address
13935 PYRAMID DR, ROGERS, AR 72758-7527
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2212010
AR
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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