Individual
GRACE LOUISE CULPEPPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2863 N OLD MISSOURI RD, STE. 112-C, FAYETTEVILLE, AR 72703-3765
(479) 200-8902
(479) 442-2881
Mailing address
2863 N OLD MISSOURI RD, STE. 112-C, FAYETTEVILLE, AR 72703-3765
(479) 200-8902
(479) 442-2881
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1729-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4A043
MEDICARE PTAN
AR
Enumeration date
02/08/2008
Last updated
08/12/2013
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