Individual
COLLIN ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADC, BS
Contact information
Practice address
1200 W WALNUT ST STE 1115, ROGERS, AR 72756-3521
(479) 785-4083
Mailing address
512 S 16TH ST, FORT SMITH, AR 72901-4628
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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