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HOLLY CANTRELL MHPP

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

Registrant NPI Number: 1407118086

Individual Registrant:
 HOLLY  CANTRELL MHPP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1825 E BROADWAY ST  FORREST CITY, AR 72335-3409 US
Tel: 870-630-2328  Fax: 870-630-2348

Contact information for business:
252 MANOR ST  MARION, AR 72364-1936 US
Tel: 870-739-6818  Fax: 870-739-6821

Registration Information:
NPI: 1407118086
Entity Type: Individual

Specialty information:

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

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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