Individual
COURTNEY ICENHOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 PEARSON, BENTON, AR 72015-4436
(501) 315-4224
(501) 778-0450
Mailing address
110 PEARSON, BENTON, AR 72015-4436
(501) 315-4224
(501) 778-0450
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/05/2020
Last updated
03/09/2022
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