Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 08-08P | AR |
Y | 103T00000X | Psychologist | 08-08P | AR |
NPI | 1003180696 |
---|---|
Provider Name | Susan Sobel |
First Address | Conway, AR 72032-5426 |
Second Address | Conway, AR 72032-5426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2012 |
Last Update Date | 29/02/2012 |