Individual
JENNIFER NILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 S RAINBOW RD, ROGERS, AR 72758-8821
(479) 254-1144
Mailing address
200 S BROADWAY ST, B, SILOAM SPRINGS, AR 72761-3130
(479) 409-8102
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
M1106001
AR
101YP2500X
Professional Counselor
Primary
P1106033
AR
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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