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General NPI Number Information
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NPI Number | 1801656301
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Entity Type | Individual
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Provider Name | MRS. MARCELINA POP
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Gender | Female
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 3155 N COLLEGE AVE STE 108
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-3500
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Country | US
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Telephone | 479-957-9121
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Fax |
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Provider Business Mailing Address
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Address Line | 1391 LAKE SEQUOYAH DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-9218
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Country | US
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Telephone | 479-283-1819
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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