Individual
TERA DACUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
1505 S. OSWEGO AVE, RUSSELLVILLE, AR 72802
(479) 967-3370
(479) 967-2775
Mailing address
PO BOX 679, MORRILTON, AR 72110-0679
(501) 354-4589
(501) 354-5410
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AR
104100000X
Social Worker
6675-M
AR
Other
Enumeration date
06/16/2011
Last updated
11/21/2014
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