| NPI | 1215438080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KEPHART Owner/Operator 479-871-7449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 2185-C) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-02-26 |