Individual
STACEY KUCHINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1502 MARY KAY BLVD, BENTON, AR 72015
(501) 315-3344
Mailing address
2615 N PRICKETT ROAD SUITE #5, BRYANT, AR 72022
(501) 416-2170
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942243571
—
AR
Enumeration date
06/13/2006
Last updated
10/08/2019
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