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ALEXANDRIA JADE PENCE

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1083126536

Individual Registrant:
 ALEXANDRIA JADE PENCE 
Gender: F
Sole Proprietor

Location and contact information for practice:
602 DAVID ST  CORNING, AR 72422-7268 US
Tel: 870-857-3655  Fax: 870-857-3667

Contact information for business:
2707 BROWNS LN  JONESBORO, AR 72401-7213 US
Tel: 870-972-4939  Fax: 870-972-4911

Registration Information:
NPI: 1083126536
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator
AR

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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