Healthcare Provider Details

I. General information

NPI: 1922194463
Provider Name (Legal Business Name): CHERIE SPENCE DULANY MS/LPE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 NORTH HAZEN AVENUE
HAZEN AR
72064
US

IV. Provider business mailing address

650 SOUTH SHACKLEFORD ROAD STE 217
LITTLE ROCK AR
72211
US

V. Phone/Fax

Practice location:
  • Phone: 870-255-3527
  • Fax: 870-255-3528
Mailing address:
  • Phone: 501-221-1843
  • Fax: 501-221-2376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number98-3E
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: