Individual
MALISSA EPHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1487 W KEISER AVE, OSCEOLA, AR 72370-2806
(870) 563-4500
(870) 563-4501
Mailing address
1217 STONE ST, JONESBORO, AR 72401-4520
(870) 972-1268
(870) 934-0487
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154356726
—
AR
Enumeration date
01/13/2016
Last updated
01/13/2016
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