Individual
MS. DEIRDRA SANDORAL KERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
1101 W 3RD ST, FORDYCE, AR 71742-3014
(870) 352-5122
(870) 352-5127
Mailing address
1101 W 3RD ST, FORDYCE, AR 71742-3014
(870) 352-5122
(870) 352-5127
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/25/2009
Last updated
11/25/2009
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