Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | P1412108 | AR |
NPI | 1003114943 |
---|---|
Provider Name | John Dan Mccuin |
First Address | Springdale, AR 72762-6683 |
Second Address | Heber Springs, AR 72543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2011 |
Last Update Date | 20/04/2020 |