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General NPI Number Information
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NPI Number | 1770572935
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Entity Type | Individual
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Provider Name | AVRAM ZOLTEN PHD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 8 SHACKLEFORD PLZ STE 201
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1853
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Country | US
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Telephone | 501-218-8999
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Fax | 501-219-8544
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Provider Business Mailing Address
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Address Line | 8 SHACKLEFORD PLZ STE 201
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1853
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Country | US
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Telephone | 501-218-8999
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Fax | 501-219-8544
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 92-17P
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 92-17P
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License Number State | AR
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