Doctor Name: | MATTHEW SUTTON |
NPI Number: | 1023296886 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC, LPE |
License Number: | P1007053 |
Business Practice Address: | 1219 Commerce Dr Suite 1 Mountain Home, AR - 726532601 |
Business Phone Number: | 8704763058 |
Business Fax Number: | 8705800732 |
Mailing Address: | 1219 Commerce Dr, Suite 1 MOUNTAIN HOME |
State: | AR |
Postal Code: | 726532601 |
Phone Number: | 8704763058 |
Fax Number: | 8705800732 |
NPI Enumeration Date: | 02/04/2008 |
NPI Last Update Date: | 01/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | P1007053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |