Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 9301002 | AR |
N | 103TS0200X | School Psychologist | 78-13E | AR |
NPI | 1003873985 |
---|---|
Provider Name | Carol Kendrick |
First Address | Springdale, AR 72764-1302 |
Second Address | Springdale, AR 72764-1302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 08/07/2007 |