Individual
KRYSTAL EAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 BROOKIDGE DRIVE, LITTLE ROCK, AR 72205
(501) 231-2612
Mailing address
15 BROOKIDGE DRIVE, LITTLE ROCK, AR 72205
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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