Individual
ILA MAUREEN DEBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4943 OLD GREENWOOD RD, SUITE 2, FORT SMITH, AR 72903-6923
(479) 719-7051
(479) 242-2653
Mailing address
5410 FREE FERRY RD, FORT SMITH, AR 72903-2522
(479) 719-7051
(479) 494-5685
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2158-C
AR
Other
Enumeration date
09/27/2007
Last updated
04/09/2015
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