Healthcare Provider Details

I. General information

NPI: 1275404279
Provider Name (Legal Business Name): MALLORY RACHEL DANEHOWER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 RIDGEWAY ST STE A&B
HOT SPRINGS AR
71901-7198
US

IV. Provider business mailing address

1707 LINWOOD DR STE B
PARAGOULD AR
72450-5365
US

V. Phone/Fax

Practice location:
  • Phone: 501-389-8100
  • Fax: 888-977-2956
Mailing address:
  • Phone: 870-604-4455
  • Fax: 888-977-2956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number22919-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: