| NPI | 1427864495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CREEL Assistant Manager 479-444-1400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-12-05 |
| Last Update Date | 2024-12-05 |