Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 98-13P | AR |
NPI | 1053345066 |
---|---|
Provider Name | Rebecca Brewer Spohn |
First Address | Little Rock, AR 72205-4023 |
Second Address | Little Rock, AR 72205-4023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 08/07/2007 |