Doctor Name: | MARY LOUISE STRAIN |
NPI Number: | 1003980236 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS LICENSED PSYCHOLO |
License Number: | 9215E |
Business Practice Address: | 350 Salem Road Suite 1 Conway, AR - 72034 |
Business Phone Number: | 5013368300 |
Business Fax Number: | 5013293572 |
Mailing Address: | 350 Salem Road Suite 1, CONWAY |
State: | AR |
Postal Code: | 72034 |
Phone Number: | 5013368300 |
Fax Number: | 5013293572 |
NPI Enumeration Date: | 11/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 9215E |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |