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Individual

AMY BETH PARTAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
28 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703
(479) 301-2284
(479) 301-2338
Mailing address
28 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703
(479) 301-2284
(479) 301-2338

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1041C0700X
Clinical Social Worker
1861-C
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5X898
BLUE SHIELD PROVIDER #
AR
Enumeration date
06/04/2006
Last updated
09/08/2022
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