Healthcare Provider Details

I. General information

NPI: 1538421276
Provider Name (Legal Business Name): MRS. VIRGINIA K ESCHBACHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 06/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 FAIRWAY AVE
NORTH LITTLE ROCK AR
72116-8066
US

IV. Provider business mailing address

4701 FAIRWAY AVE
NORTH LITTLE ROCK AR
72116-8066
US

V. Phone/Fax

Practice location:
  • Phone: 501-771-8261
  • Fax: 501-771-8263
Mailing address:
  • Phone: 501-771-8261
  • Fax: 501-771-8263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: