Individual
MAURY BRUTON MCCORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1127 SECOND ST, LAKE VILLAGE, AR 71653-1541
(870) 265-3808
(870) 265-2733
Mailing address
790 ROBERTS DR, MONTICELLO, AR 71655-5723
(870) 367-2461
(870) 460-6133
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A0901003
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018205
—
MS
Enumeration date
01/15/2008
Last updated
02/27/2009
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