| Fresh Roots Family Counseling | |
|
318 W Poplar St Rogers AR 72756-4559 | |
| (479) 986-8655 | |
| (479) 633-9398 |
| Full Name | Fresh Roots Family Counseling |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 318 W Poplar St, Rogers, Arkansas |
| Authorized Official Name and Position | Dell Christy Tyson (CO-DIRECTOR) |
| Authorized Official Contact | 4799868655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Roots Family Counseling 318 W Poplar St Rogers AR 72756-4559 Ph: (479) 986-8655 | Fresh Roots Family Counseling 318 W Poplar St Rogers AR 72756-4559 Ph: (479) 986-8655 |
| NPI Number | 1053479634 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053479634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | P9201002 (Arkansas) | Primary |
| 106H00000X | Marriage & Family Therapist | M9710002 (Arkansas) | Primary |
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