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General NPI Number Information
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NPI Number | 1669151411
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Entity Type | Individual
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Provider Name | ALICIA DANILLE ARTISON MSW
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Gender | Female
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 606 MEDICAL PKWY
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City | ENTERPRISE
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State | OR
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Zip | 97828-5140
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Country | US
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Telephone | 541-426-4524
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Fax |
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Provider Business Mailing Address
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Address Line | 1169 W CRANE DR
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City | NIXA
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State | MO
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Zip | 65714-7412
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Country | US
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Telephone | 336-987-3282
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | OR
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