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General NPI Number Information
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NPI Number | 1114145919
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Entity Type | Individual
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Provider Name | VELMA LOUISE BALTIMORE PH.D
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2106 BROWN ST
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City | LITTLE ROCK
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State | AR
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Zip | 72204-4158
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Country | US
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Telephone | 501-663-1873
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Fax |
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Provider Business Mailing Address
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Address Line | 2106 BROWN STREET
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City | LITTLE ROCK
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State | AR
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Zip | 72204
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Country | US
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Telephone | 501-663-1873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | P8102
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License Number State | AR
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