Healthcare Provider Details

I. General information

NPI: 1528310752
Provider Name (Legal Business Name): HOLLY LOIS DUCK LPC,NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E CRANDALL AVE STE B
HARRISON AR
72601-3628
US

IV. Provider business mailing address

821 W RIDGE AVE
HARRISON AR
72601-3337
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-8484
  • Fax: 870-741-4088
Mailing address:
  • Phone: 870-577-3163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1507078
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: