Healthcare Provider Details

I. General information

NPI: 1922004787
Provider Name (Legal Business Name): CARA R. HARTFIELD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 12/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W CENTER ST SUITE 215
FAYETTEVILLE AR
72701-6034
US

IV. Provider business mailing address

112 W CENTER ST SUITE 215
FAYETTEVILLE AR
72701-6034
US

V. Phone/Fax

Practice location:
  • Phone: 479-409-2212
  • Fax: 479-439-8550
Mailing address:
  • Phone: 479-409-2212
  • Fax: 479-439-8550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2001024792
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number06-15 P
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: