Healthcare Provider Details

I. General information

NPI: 1841017993
Provider Name (Legal Business Name): SCARLETT A CALLEN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116A NORTH ST
CAVE CITY AR
72521-9019
US

IV. Provider business mailing address

122 JUDGE ANDERSON RD
STRAWBERRY AR
72469-8034
US

V. Phone/Fax

Practice location:
  • Phone: 870-384-0813
  • Fax:
Mailing address:
  • Phone: 870-384-0813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number8728
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: