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General NPI Number Information
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NPI Number | 1023889508
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Entity Type | Organization
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Legal Business Name | BDUB COUNSELING
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 3017 S 70TH ST STE FGH
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City | FORT SMITH
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State | AR
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Zip | 72903-5049
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Country | US
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Telephone | 479-222-6210
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Fax | 479-222-6895
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Provider Business Mailing Address
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Address Line | 3017 S 70TH ST STE FGH
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City | FORT SMITH
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State | AR
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Zip | 72903-5049
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Country | US
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Telephone | 479-222-6210
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Fax | 479-222-6895
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM BRADLEY WALKER
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Credential | LPC, LMFT
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Telephone | 479-414-6240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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