Individual
STACEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
802 E 3RD ST, HOPE, AR 71801-5503
(870) 722-8041
(870) 722-6901
Mailing address
602 N WALTON BLVD, BENTONVILLE, AR 72712-4576
(479) 464-1060
(479) 271-6307
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/22/2017
Last updated
06/22/2017
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