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Individual

DR. MARY MOORE EKDAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
4004 MCCAIN BLVD, SUITE 203, NORTH LITTLE ROCK, AR 72116-8057
(501) 812-4268
(501) 812-4286
Mailing address
4004 MCCAIN BLVD, SUITE 203, NORTH LITTLE ROCK, AR 72116-8057
(501) 812-4268
(501) 812-4286

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
964P
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139320719
AR
Enumeration date
05/05/2006
Last updated
03/08/2013
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