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General NPI Number Information
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NPI Number | 1194241463
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Entity Type | Organization
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Legal Business Name | WENDY NEWSAM PLLC
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 1 INNWOOD CIRCLE SUITE 107
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City | LITTLE ROCK
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State | AR
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Zip | 72211
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Country | US
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Telephone | 501-228-5506
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Fax | 501-228-5506
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Provider Business Mailing Address
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Address Line | 10 FAIR OAKS DRIVE
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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 | 501-240-9574
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MS. WENDY DAWN NEWSAM
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Credential | MS, LPE-I
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Telephone | 501-228-5506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 13-26EI
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License Number State | AR
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