Capps, Charley Marissa
Capps, Charley Marissa is an sole proprietor health care provider with primary practice located at 212 S Lincoln St Ste A , Lowell AR 72745-9722. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Capps, Charley Marissa can be contacted via phone (479) 770-0744.Contact Information
Primary practice address
212 S Lincoln St Ste A
Lowell AR 72745-9722
Phone: (479) 770-0744
Fax: (479) 770-0176
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1578184982 |
|---|---|
| LBN Legal business name | Capps, Charley Marissa |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 27th, 2020 |
| Last updated | Jan 9th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578184982 | NPPES |
| Arkansas | MEDICAID | 274145706 |
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