| Doctor Name: | CAROL MARIE KRETZMANN |
| NPI Number: | 1033163175 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | P0802018 |
| Business Practice Address: | 132 Lower Ridge Rd Conway, AR - 720328518 |
| Business Phone Number: | 5015489905 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1589, BENTON |
| State: | AR |
| Postal Code: | 720181589 |
| Phone Number: | 5013153344 |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2006 |
| NPI Last Update Date: | 05/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | P0802018 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |