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Individual

GREGORY WAYNE EDGIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
3601 RICHARDS RD, NORTH LITTLE ROCK, AR 72117-2954
(501) 221-1843
Mailing address
3601 RICHARDS RD, NORTH LITTLE ROCK, AR 72117-2954
(501) 221-1843

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A1705213
AR
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
08/22/2016
Last updated
07/21/2022
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