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Individual

JASON KUSHNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
(501) 332-4403
Mailing address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
(501) 332-4403

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A0901018
AR

Other

Enumeration date
09/22/2009
Last updated
09/22/2009
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