Individual
MR. RICHARD WAYNE IRVIN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN, MHPP
Contact information
Practice address
1817 WOODSPRINGS RD, STE G, JONESBORO, AR 72401-0903
(870) 934-9800
(870) 934-8463
Mailing address
5537 BLEAUX AVE, SPRINGDALE, AR 72762-0737
(479) 872-5580
(479) 872-5581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
L45386
AR
Other
Enumeration date
09/25/2008
Last updated
09/25/2008
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