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JOLENE BENEDICT

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

Registrant NPI Number: 1578730255

Individual Registrant:
 JOLENE  BENEDICT 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
700 S MAIN ST  MOUNTAIN HOME, AR 72653-4445 US
Tel: 870-425-1041  Fax: 870-425-1049

Contact information for business:
4508 STADIUM BLVD  JONESBORO, AR 72404-9675 US
Tel: 870-933-6886  Fax: 870-933-9395

Registration Information:
NPI: 1578730255
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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