Organization
FORDYCE COUNSELING CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL LOYD MOORE M.S., L.A.C. (PRESIDENT)
(870) 352-5122
Entity
Organization
Contact information
Practice address
1101 W 3RD ST, FORDYCE, AR 71742-3014
(870) 352-5122
(870) 352-5127
Mailing address
1101 W 3RD ST, FORDYCE, AR 71742-3014
(870) 352-5122
(870) 352-5127
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/16/2006
Last updated
08/22/2020
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