| NPI | 1235424326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE A BLANCHARD Owner 479-567-5654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AR 09-16P) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AR 09-16P) |
| 101Y00000X Counselor (Licence: AR P1611170) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2018-01-08 |