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General NPI Number Information
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NPI Number | 1093349995
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Entity Type | Organization
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Legal Business Name | GAP RELIEF
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Dates
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Enumeration Date | 02/28/2020
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 6733 SUNSET RIDGE CIR
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City | SPRINGDALE
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State | AR
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Zip | 72762-8162
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Country | US
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Telephone | 479-595-2228
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7708
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City | SPRINGDALE
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State | AR
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Zip | 72766-7708
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-DIRECTOR
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Name | MEGAN TAYLOR
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Credential | MS, LPC, LMFT
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Telephone | 479-903-2478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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