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MINNIE ETHEL WASHINGTON CIT MMPH
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1083946354
Individual Registrant: MINNIE ETHEL WASHINGTON CIT MMPH
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
900 W POPLAR ST STE 100 MC CRORY, AR 72101-8266 US
Tel: 866-533-1757 Fax: --
Tel: 866-533-1757 Fax: --
Contact information for business:
P.O. BOX 2578 BATVILLE, AR 72501 US
Tel: 870-793-8900 Fax: 870-633-2624
Tel: 870-793-8900 Fax: 870-633-2624
Registration Information:
NPI: 1083946354
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
