Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | P9411027 | AR |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | A-215 | AR |
NPI | 1003027061 |
---|---|
Provider Name | Dr. William Coke Viser |
First Address | Arkadelphia, AR 71923-3626 |
Second Address | Arkadelphia, AR 71923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
M9711036 | LMFT (01) | AR |
P9411027 | LPC (01) | AR |