Healthcare Provider Details

I. General information

NPI: 1477290476
Provider Name (Legal Business Name): ARLINDA BLACKWELL-EL HOLISTIC PRACTITIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARLINDA BLACKWELL HOLISTIC PRACTITIONE

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 CHESTNUT ST STE 102
CONWAY AR
72032-5434
US

IV. Provider business mailing address

2200 MEADOWLAKE RD APT 413
CONWAY AR
72032-2548
US

V. Phone/Fax

Practice location:
  • Phone: 501-205-1178
  • Fax:
Mailing address:
  • Phone: 607-760-9608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: