| NPI | 1134900038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIE ALEXA DAWN BARNES Psychologist 479-719-7847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2023-10-09 |