Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 10-09EI | AR |
NPI | 1003193822 |
---|---|
Provider Name | Mrs. Adrienne Reeves |
First Address | Conway, AR 72032-7836 |
Second Address | Little Rock, AR 72205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2011 |
Last Update Date | 30/08/2018 |