Individual
KANAKA HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2003 SE WALTON BLVD, BENTONVILLE, AR 72712
(479) 750-2020
(479) 750-4843
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4286-M
AR
1041C0700X
Clinical Social Worker
Primary
4286-C
AR
Other
Enumeration date
11/12/2008
Last updated
07/09/2018
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