Individual
DR. JASON LAGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11 CHILDRENS WAY, SLOT 654, LITTLE ROCK, AR 72202-3500
(501) 364-5150
(501) 364-1592
Mailing address
11 CHILDRENS WAY, SLOT 654, LITTLE ROCK, AR 72202-3500
(501) 364-5150
(501) 364-1592
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10-18P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170484795
—
AR
Enumeration date
10/23/2008
Last updated
08/18/2010
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