Healthcare Provider Details

I. General information

NPI: 1629264742
Provider Name (Legal Business Name): AMY MARIE MUSE L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 MEADOWLANDS DR
CENTERTON AR
72719-9228
US

IV. Provider business mailing address

710 S HOLLY ST STE 10
SILOAM SPRINGS AR
72761-3304
US

V. Phone/Fax

Practice location:
  • Phone: 870-260-9897
  • Fax: 501-226-2632
Mailing address:
  • Phone: 479-524-8618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: