| NPI | 1265892087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L SHASTEEN Behavioral Health Therapist 479-876-8626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR C-1285) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |