| NPI | 1003425703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH RACKLEY Office Manager 479-242-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2020-07-28 |