Individual
ASHLEY DONALDSON WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1101 MORGAN ST, SUITE 8, PARAGOULD, AR 72450-3949
(870) 335-9483
(870) 335-9487
Mailing address
1815 PLEASANT GROVE RD, JONESBORO, AR 72401-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6439-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183586795
—
AR
01
—
5MM24
BCBS
AR
Enumeration date
06/29/2011
Last updated
04/30/2021
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