| Life Trek, Llc | |
|
21 Sycamore St Cabot AR 72023-3714 | |
| (501) 617-5678 | |
| Not Available |
| Full Name | Life Trek, Llc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 21 Sycamore St, Cabot, Arkansas |
| Authorized Official Name and Position | Cathy Lynn Staton (PSYCHOLOGIST) |
| Authorized Official Contact | 5016175678 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Trek, Llc 21 Sycamore St Cabot AR 72023-3714 Ph: (501) 617-5678 | Life Trek, Llc 21 Sycamore St Cabot AR 72023-3714 Ph: (501) 617-5678 |
| NPI Number | 1861925968 |
|---|---|
| Provider Enumeration Date | 04/05/2017 |
| Last Update Date | 04/05/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861925968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 17-04P (Arkansas) | Primary |
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