Basic Information
| Provider Information | |||||||||
| NPI: | 1356733398 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ENGLISH | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | LAUREN | ||||||||
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| Credential: | LAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1249 LAKESIDE RD | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719017354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012622766 | ||||||||
| FaxNumber: | 5012622544 | ||||||||
| Practice Location | |||||||||
| Address1: | 1249 LAKESIDE RD | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719017354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012622766 | ||||||||
| FaxNumber: | 5012622544 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2015 | ||||||||
| LastUpdateDate: | 10/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | A1607091 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.