Doctor Name: | ALCANIO SHANKS |
NPI Number: | 1710341425 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 4323 Jefferson Ave Texarkana, AR - 718541515 |
Business Phone Number: | 8707730700 |
Business Fax Number: | 8707730705 |
Mailing Address: | 602 N Walton Blvd, BENTONVILLE |
State: | AR |
Postal Code: | 727124576 |
Phone Number: | 4794641060 |
Fax Number: | 4792716307 |
NPI Enumeration Date: | 04/08/2016 |
NPI Last Update Date: | 04/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |