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Individual

PEYTON ELAINE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
QBHP

Contact information

Practice address
2403 MAIN DR STE 1&2, FAYETTEVILLE, AR 72704-5223
(479) 967-2322
(479) 967-2876
Mailing address
PO BOX 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
09/17/2019
Last updated
09/17/2019
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