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NPI Code Detail

MEDICARE: MS. MONICA ROBERTS L.P.E.

MEDICARE: MS. MONICA ROBERTS L.P.E.
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
1101Y00000XCounselor94-15EAR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2201829OTHERARVALUE OPTIONS
35T182OTHERARBLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number : 1376516898
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MONICA ROBERTS L.P.E.
Provider Business Mailing Address
First Line : 125 DONS WAY
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913
Country : US
Telephone Number : 501-620-5130
Fax Number : 501-620-5109
Provider Business Practice Location Address
First Line : 1615 MARTIN LUTHER KING BLVD
Second Line :
City : MALVERN
State : AR
Zip : 72104-2233
Country : US
Telephone Number : 501-332-5236
Fax Number : 501-620-5109
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 12/17/2008

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