Individual
VICKIE SUE POULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1004A S MAIN ST, BERRYVILLE, AR 72616-4330
(870) 423-1077
(870) 423-1087
Mailing address
705 S SPRINGFIELD AVE, GREEN FOREST, AR 72638-3538
(870) 423-1077
(870) 423-1087
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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