Healthcare Provider Details

I. General information

NPI: 1669985172
Provider Name (Legal Business Name): JENNIFER BIGGERS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4206 PRINCE ST
CONWAY AR
72034-9398
US

IV. Provider business mailing address

4206 PRINCE ST
CONWAY AR
72034-9398
US

V. Phone/Fax

Practice location:
  • Phone: 501-932-0255
  • Fax: 501-932-0258
Mailing address:
  • Phone: 501-932-0255
  • Fax: 501-932-0258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number18-09P
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18-09P
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number18-09P
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: