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General NPI Number Information
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NPI Number | 1003492869
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Entity Type | Organization
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Legal Business Name | M & J MENTAL HEALTH AND WELLNESS
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 2796 S 2ND ST STE E
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City | CABOT
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State | AR
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Zip | 72023-7043
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Country | US
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Telephone | 501-286-6086
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Fax | 501-286-6046
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Provider Business Mailing Address
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Address Line | PO BOX 559
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City | CABOT
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State | AR
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Zip | 72023-0559
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Country | US
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Telephone | 501-286-6086
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Fax | 501-286-6046
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER PRICE
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Credential | DNP
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Telephone | 501-286-6086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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