Healthcare Provider Details

I. General information

NPI: 1548607161
Provider Name (Legal Business Name): DEANNA HARDIMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEANNA LATOYA HEMPHILL MHPP

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S ROSE ST
SHERIDAN AR
72150
US

IV. Provider business mailing address

201 S ROSE ST
SHERIDAN AR
72150-2451
US

V. Phone/Fax

Practice location:
  • Phone: 870-917-2171
  • Fax: 870-917-2161
Mailing address:
  • Phone: 870-917-2171
  • Fax: 870-917-2161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1710371
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: