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General NPI Number Information
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NPI Number | 1649560376
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Entity Type | Organization
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Legal Business Name | ALLIANT BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 04/14/2011
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 1511 W SEVIER ST
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City | BENTON
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State | AR
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Zip | 72019-2437
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Country | US
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Telephone | 501-205-0703
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Fax | 501-778-4889
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Provider Business Mailing Address
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Address Line | PO BOX 280
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City | BENTON
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State | AR
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Zip | 72018-0280
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Country | US
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Telephone | 501-205-0703
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Fax | 501-778-4889
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHANNON DOUGLAS PARSONS
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Credential | PSY.D.
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Telephone | 501-205-0703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 10-25P
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License Number State | AR
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