Individual
LYDIA HOPE THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1815 PLEASANT GROVE RD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Mailing address
1815 PLEASANT GROVE RD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AR
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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