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

Registrant NPI Number: 1881720019

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
Tel: 479-967-5570  Fax: 479-890-5364

Contact information for business:
Tel: 479-967-5570  Fax: 479-890-5364

Registration Information:
NPI: 1881720019
Entity Type: Individual

Specialty information:

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

Legacy codes, insurance codes and state license numbers:



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