IVELISSE PENNINGTON

FAYETTEVILLE, AR
NPI1679817670
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2012-11-15
Last Update Date2012-11-15
Business Address
-- IVELISSE PENNINGTON MHPP
4253 N CROSSOVER RD
FAYETTEVILLE, AR 72703-4593
Phone number: 479-521-5731
Mailing Address
-- IVELISSE PENNINGTON MHPP
3352 N FUTRALL DR
FAYETTEVILLE, AR 72703-4057
Phone number: 479-521-1427