| John L. Shasteen Llc | |
|
1803 Sw Regional Airport Blvd Ste 5 Bentonville AR 72712-8792 | |
| (479) 876-8626 | |
| (479) 876-8636 |
| Full Name | John L. Shasteen Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1803 Sw Regional Airport Blvd Ste 5, Bentonville, Arkansas |
| Authorized Official Name and Position | John L Shasteen (BEHAVIORAL HEALTH THERAPIST) |
| Authorized Official Contact | 4798768626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John L. Shasteen Llc 1803 Sw Regional Airport Blvd Ste 5 Bentonville AR 72712-8792 Ph: (479) 876-8626 | John L. Shasteen Llc 1803 Sw Regional Airport Blvd Ste 5 Bentonville AR 72712-8792 Ph: (479) 876-8626 |
| NPI Number | 1265892087 |
|---|---|
| Provider Enumeration Date | 03/07/2016 |
| Last Update Date | 03/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265892087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C-1285 (Arkansas) | Primary |
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