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Individual

MISTY L WINTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1127 SECOND ST, LAKE VILLAGE, AR 71653-1541
(870) 265-3808
(870) 265-2733
Mailing address
1127 SECOND ST, LAKE VILLAGE, AR 71653-1541
(870) 265-3808
(870) 265-2733

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1962-M
AR
1041C0700X
Clinical Social Worker
Primary
2458-C
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
169134795
AR
Enumeration date
08/16/2006
Last updated
02/16/2010
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