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General NPI Number Information
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NPI Number | 1790398899
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Entity Type | Individual
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Provider Name | CAROL B LESTER
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Gender | Female
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 204 S 24TH ST
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City | ROGERS
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State | AR
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Zip | 72758-1129
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Country | US
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Telephone | 479-621-0301
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Fax | 479-899-6300
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Provider Business Mailing Address
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Address Line | 34 S PALMER AVE
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5446
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Country | US
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Telephone | 870-703-0800
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P0802022
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License Number State | AR
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