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General NPI Number Information
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NPI Number | 1669853081
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Entity Type | Organization
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Legal Business Name | ARKANSAS ADULT PSYCHOTHERAPY CENTER, PLLC
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 5401 JFK STE I
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-6740
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Country | US
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Telephone | 501-771-4693
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Fax | 501-771-4885
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Provider Business Mailing Address
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Address Line | 5401 JFK BLVD STE I
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-6740
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Country | US
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Telephone | 501-758-9993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAHLIA DANNETTA DISTIN
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Credential |
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Telephone | 501-758-9993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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