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1346679636
MANDA J DAVIS
BENTONVILLE, AR
NPI
1346679636
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AR 365L)
Enumeration Date
2013-11-06
Last Update Date
2013-11-06
Business Address
-- MANDA J DAVIS LADAC,BCC
1002 SE C ST
BENTONVILLE, AR 72712-6327
Phone number: 479-271-2120
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Mailing Address
-- MANDA J DAVIS LADAC,BCC
1002 SE C ST
BENTONVILLE, AR 72712-6327
Phone number: 479-271-2120
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