Individual
CLARENCE KEVIN BEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
204 S 24TH ST, ROGERS, AR 72758-1129
(479) 621-0301
(479) 899-6300
Mailing address
204 S 24TH ST, ROGERS, AR 72758-1129
(479) 621-0301
(479) 899-6300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
P1003022
AR
101YP2500X
Professional Counselor
Primary
P1003022
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P1003022
AR LICENSE
AR
Enumeration date
09/09/2009
Last updated
03/17/2018
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