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General NPI Number Information
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NPI Number | 1396534863
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Entity Type | Organization
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Legal Business Name | START ONLINE THERAPY, PLLC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 1587 MOUNTAIN SPRINGS RD
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City | CABOT
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State | AR
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Zip | 72023-2015
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Country | US
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Telephone | 501-551-0613
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Fax | 800-551-9389
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Provider Business Mailing Address
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Address Line | 1587 MOUNTAIN SPRINGS RD
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City | CABOT
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State | AR
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Zip | 72023-2015
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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 | PSYCHOLOGIST/OWNER
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Name | DR. ANGIE ELIZANDRO
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Credential | PH.D.
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Telephone | 501-551-0613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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