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NPI Code Detail

MEDICARE: VICKI M MCGOWAN MHPP

MEDICARE: VICKI M MCGOWAN MHPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1285884981
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI M MCGOWAN MHPP
Provider Business Mailing Address
First Line : 7107 W 12TH ST STE 201
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-2451
Country : US
Telephone Number : 501-663-1837
Fax Number : 501-663-1839
Provider Business Practice Location Address
First Line : 7107 W 12TH ST STE 201
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-2451
Country : US
Telephone Number : 501-663-1837
Fax Number : 501-663-1839
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2008
Last Update Date : 09/30/2008

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Directions to “ VICKI M MCGOWAN MHPP” Practice Location

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