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General NPI Number Information
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NPI Number | 1306953955
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Entity Type | Individual
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Provider Name | R. JOSETTE CLINE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 W SUNBRIDGE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-1825
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Country | US
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Telephone | 479-444-7575
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Fax | 479-443-9554
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Provider Business Mailing Address
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Address Line | 1748 N APPLEBURY PL
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-2505
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Country | US
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Telephone | 479-251-7798
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 01-05P
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License Number State | AR
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