Healthcare Provider Details

I. General information

NPI: 1508788274
Provider Name (Legal Business Name): WILLOW KASINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW BROAD ST
HOXIE AR
72433-2419
US

IV. Provider business mailing address

1830 E JOHNSON AVE
JONESBORO AR
72401-1339
US

V. Phone/Fax

Practice location:
  • Phone: 870-558-9234
  • Fax: 877-447-5311
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: