Individual
MS. MARY ANN CALLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPE
Contact information
Practice address
212 W SEVIER STREET, BENTON, AR 72015
(501) 776-0500
(501) 776-0507
Mailing address
212 W SEVIER STREET, BENTON, AR 72015
(501) 776-0500
(501) 776-0507
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
92-05 LPE-I
AR
101YM0800X
Mental Health Counselor
Primary
92-5E
AR
Other
Enumeration date
02/09/2007
Last updated
03/24/2008
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