Individual
MR. JAYSON TODD CRISP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
229 A ST, MAGNOLIA, AR 71753-3653
(870) 234-2600
Mailing address
124 S JACKSON ST, MAGNOLIA, AR 71753-3526
(870) 234-6550
(870) 234-3822
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
MENTAL HEALTH PARAPROFESSIONAL
AR
Enumeration date
12/29/2008
Last updated
12/29/2008
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