Individual
JONNA L. HUSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3111 S 70TH ST, FORT SMITH, AR 72903-5017
(800) 465-3203
Mailing address
3111SOUTH 70TH ST., FORT SMITH, AR 72903
(800) 465-3203
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1638-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178595719
—
AR
01
—
5X313
BLUE SHIELD PROVIDER #
AR
Enumeration date
06/12/2006
Last updated
12/11/2013
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