| Crucible Llc | |
|
1 W Sunbridge Dr Fayetteville AR 72703-1825 | |
| (970) 903-3441 | |
| Not Available |
| Full Name | Crucible Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1 W Sunbridge Dr, Fayetteville, Arkansas |
| Authorized Official Name and Position | Melia Ann Snyder (PRESIDENT) |
| Authorized Official Contact | 9709033441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crucible Llc 219 W Willow St Rogers AR 72756-5450 Ph: (970) 903-3441 | Crucible Llc 1 W Sunbridge Dr Fayetteville AR 72703-1825 Ph: (970) 903-3441 |
| NPI Number | 1992560155 |
|---|---|
| Provider Enumeration Date | 02/16/2024 |
| Last Update Date | 02/16/2024 |
| Certification Date | 02/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992560155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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