Healthcare Provider Details

I. General information

NPI: 1851790364
Provider Name (Legal Business Name): RASHIDAT KATRICE WRIGHT-HILL INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 08/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 FRANKIE LN
WHITE HALL AR
71602-2699
US

IV. Provider business mailing address

2806 BELMOOR DR
PINE BLUFF AR
71601-5592
US

V. Phone/Fax

Practice location:
  • Phone: 870-247-2305
  • Fax: 870-247-2330
Mailing address:
  • Phone: 870-324-0754
  • Fax: 870-534-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: