Organization
MOSAIC COUNSELING AND CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN A MARTIN PHD, LPC-S (OWNER)
(479) 263-7567
Entity
Organization
Contact information
Practice address
1401 S WALDRON RD, SUITE 200, FORT SMITH, AR 72903-2591
(479) 263-7567
(479) 452-2958
Mailing address
PO BOX 10124, FAYETTEVILLE, AR 72703-0037
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0610054
AR
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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