Healthcare Provider Details

I. General information

NPI: 1326277252
Provider Name (Legal Business Name): KAMRA ELIZABETH MAYS, PHD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 S WALTON BLVD STE 6
BENTONVILLE AR
72712
US

IV. Provider business mailing address

1426 WATER WAY DR
CAVE SPRINGS AR
72718
US

V. Phone/Fax

Practice location:
  • Phone: 870-939-7606
  • Fax:
Mailing address:
  • Phone: 870-939-7606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number07-13P
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number07-13P
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number07-13P
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number07-13P
License Number StateAR
# 5
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number07-13P
License Number StateAR

VIII. Authorized Official

Name: KAMRA ELIZABETH MAYS
Title or Position: CEO/PSYCHOLOGIST
Credential: PH.D.
Phone: 870-939-7606