Individual
MARY GRACE MACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
12921 CANTRELL RD STE 105, LITTLE ROCK, AR 72223-1798
(501) 891-5492
Mailing address
12921 CANTRELL RD STE 105, LITTLE ROCK, AR 72223-1798
(501) 891-5492
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10428-M
AR
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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