| NPI | 1053566356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI ANN TUCKER CEO Interim 479-452-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 101Y00000X Counselor | |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2019-09-03 |