Individual
JASMINE CHEYENNE ICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 HWY 5 N STE 2, BRYANT, AR 72019-9103
(501) 777-5969
Mailing address
6212 MILSAP DR, ALEXANDER, AR 72002-7039
(870) 730-8837
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2204018
AR
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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