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General NPI Number Information
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NPI Number | 1629654025
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Entity Type | Organization
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Legal Business Name | THE DARING SPACE - A PRIVATE THERAPY PRACTICE
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 203 MERRIMAN AVE E
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City | WYNNE
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State | AR
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Zip | 72396-2943
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Country | US
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Telephone | 870-375-2042
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SHANNON DR
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City | WYNNE
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State | AR
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Zip | 72396-2536
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Country | US
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Telephone | 870-253-1570
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | HELEN JENNINGS-HOOD
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Credential | LPC
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Telephone | 870-375-2042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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