Healthcare Provider Details

I. General information

NPI: 1972611424
Provider Name (Legal Business Name): TERRY LAYNE EFIRD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S MAIN
SPRINGDALE AR
72764
US

IV. Provider business mailing address

106 S MAIN
SPRINGDALE AR
72764
US

V. Phone/Fax

Practice location:
  • Phone: 479-751-7074
  • Fax: 479-756-1727
Mailing address:
  • Phone: 479-751-7074
  • Fax: 479-756-1727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number952P
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: