Healthcare Provider Details

I. General information

NPI: 1023849858
Provider Name (Legal Business Name): FLEURI, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 08/13/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SE OTIS CORLEY DR STE 14
BENTONVILLE AR
72712-4184
US

IV. Provider business mailing address

1600 S 22ND ST
ROGERS AR
72758-5600
US

V. Phone/Fax

Practice location:
  • Phone: 318-245-3437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY GAIL LANE
Title or Position: OWNER
Credential: PHD
Phone: 318-245-3437