MEDICARE: CARA R. HARTFIELD PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2001024792	MO
2	103TC0700X	Clinical Psychologist	06-15 P	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922004787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA R. HARTFIELD PHD

Provider Business Mailing Address
First Line	:	112 W CENTER ST
Second Line	:	SUITE 215
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72701-6034
Country	:	US
Telephone Number	:	479-409-2212
Fax Number	:	479-439-8550

Provider Business Practice Location Address
First Line	:	112 W CENTER ST
Second Line	:	SUITE 215
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72701-6034
Country	:	US
Telephone Number	:	479-409-2212
Fax Number	:	479-439-8550

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	12/04/2009

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Directions to “ CARA R. HARTFIELD PHD” Practice Location

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