| NPI | 1962636563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M HUNTER Licensed Clinical Social Worker 479-206-3627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AR 2505-C) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL SW3309) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2021-07-23 |