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Individual

KELSEY SANDEFUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC, NCC

Contact information

Practice address
17 BUSINESS PARK DR STE 12, GREENBRIER, AR 72058-9295
(501) 733-1453
(501) 426-8091
Mailing address
17 BUSINESS PARK DR STE 13, GREENBRIER, AR 72058-9295
(501) 733-1453
(501) 426-8091

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
A1903039
AR
101YP2500X
Professional Counselor
Primary
P2102153
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
263513719
AR
Enumeration date
03/20/2019
Last updated
12/02/2021
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