Organization
SUBLETTE THERAPEUTIC SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY CHARLES SUBLETTE LCSW (OWNER)
(501) 352-2429
Entity
Organization
Contact information
Practice address
2001 CLUB MANOR DR, SUITE D, MAUMELLE, AR 72113-7411
(501) 352-2429
Mailing address
32 BELLE RIVER CV, MAUMELLE, AR 72113-7024
(501) 352-2429
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6904-C
AR
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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