Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MANDA J DAVIS, LADAC,BCC
Active Sole ProprietorAddiction (Substance Use Disorder) Counselor · BENTONVILLE, AR
Registration Details
- NPI Number
- 1346679636
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 6, 2013 (12.4580500616 yrs)
- Last Updated
- Nov 6, 2013
- License
-
365L (AR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1002 SE C STBENTONVILLE, AR, 727126327Browse AR providers · Browse ZIP 72712
- Phone
- 4792712120
- Fax
- 4792712219
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in BENTONVILLE, AR
| Name | Credential | NPI |
|---|---|---|
| MR. KENNETH WAYNE DAVIS | SAC | 1124384359 |
| MATTHEW WALKER LONG | MA | 1366871642 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.