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1679817670
IVELISSE PENNINGTON
FAYETTEVILLE, AR
NPI
1679817670
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-11-15
Last Update Date
2012-11-15
Business Address
-- IVELISSE PENNINGTON MHPP
4253 N CROSSOVER RD
FAYETTEVILLE, AR 72703-4593
Phone number: 479-521-5731
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Mailing Address
-- IVELISSE PENNINGTON MHPP
3352 N FUTRALL DR
FAYETTEVILLE, AR 72703-4057
Phone number: 479-521-1427
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