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MS. MATTIE LAVON WHALEY

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

Registrant NPI Number: 1023203064

Individual Registrant:
MS. MATTIE LAVON WHALEY 
Gender: F
Sole Proprietor

Location and contact information for practice:
29 BAPTIST DR  STAR CITY, AR 71667-8505 US
Tel: 870-718-7201  Fax: --

Contact information for business:
29 BAPTIST DR  STAR CITY, AR 71667-8505 US
Tel: 870-718-7201  Fax: --

Registration Information:
NPI: 1023203064
Entity Type: Individual

Specialty information:

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

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
3014230001AR05




HEALTH CARE JOBS AR - Page 1



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