Healthcare Provider Details

I. General information

NPI: 1730026048
Provider Name (Legal Business Name): LATRICIA CHALMERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 N MAIN ST
WALDRON AR
72958-8338
US

IV. Provider business mailing address

PO BOX 173
WALDRON AR
72958-0173
US

V. Phone/Fax

Practice location:
  • Phone: 479-207-0559
  • Fax: 479-777-7637
Mailing address:
  • Phone: 479-207-0559
  • Fax: 479-777-7637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: