Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003142407 |
---|---|
Provider Name | Colleen Stone |
First Address | Little Rock, AR 72210-5323 |
Second Address | Little Rock, AR 72210-5323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2009 |
Last Update Date | 20/10/2009 |