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General NPI Number Information
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NPI Number | 1720405244
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Entity Type | Individual
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Provider Name | AVIS K. PHIFER LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 2904 ARKANSAS BLVD
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City | TEXARKANA
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State | AR
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Zip | 71854-2536
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Country | US
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Telephone | 870-773-4655
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Fax | 870-772-4640
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Provider Business Mailing Address
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Address Line | PO BOX 1987
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City | TEXARKANA
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State | TX
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Zip | 75504-1987
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Country | US
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Telephone | 870-773-4655
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Fax | 870-772-4640
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | PLMSW
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 12926-M
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License Number State | AR
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