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General NPI Number Information
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NPI Number | 1679029201
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Entity Type | Individual
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Provider Name | ARIC BOKKER
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Gender | Male
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 2012 HIGHWAY 62 412
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City | HIGHLAND
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State | AR
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Zip | 72542-9477
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Country | US
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Telephone | 870-856-3337
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Fax | 870-856-3334
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Provider Business Mailing Address
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Address Line | PO BOX 176
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City | CHEROKEE VILLAGE
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State | AR
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Zip | 72525-0176
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Country | US
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Telephone | 870-257-3336
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Fax | 870-257-3339
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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 | P1901006
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License Number State | AR
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