| NPI | 1821305186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DOUGLAS CHIOVOLONI Clinical Social Worker 479-494-7889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AR 2295-CP) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AR 02511) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2014-08-11 |