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NPI Code Detail

MEDICARE: KASIE EARNEST MHPP

MEDICARE: KASIE EARNEST 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 : 1639466071
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASIE EARNEST MHPP
Provider Business Mailing Address
First Line : 1104 N COLLEGE ST
Second Line :
City : HUNTSVILLE
State : AR
Zip : 72740-9672
Country : US
Telephone Number : 479-750-2020
Fax Number : 479-750-8967
Provider Business Practice Location Address
First Line : 1104 N COLLEGE ST
Second Line :
City : HUNTSVILLE
State : AR
Zip : 72740-9672
Country : US
Telephone Number : 479-750-2020
Fax Number : 479-750-8967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2011
Last Update Date : 07/06/2011

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Directions to “ KASIE EARNEST MHPP” Practice Location

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