Ekdahl, Mary Moore
Ekdahl, Mary Moore is an individual health care provider with primary practice located at 4004 Mccain Blvd Suite 203, North Little Rock AR 72116-8057. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ekdahl, Mary Moore can be contacted via phone (501) 812-4268.Contact Information
Primary practice address
4004 Mccain Blvd Suite 203
North Little Rock AR 72116-8057
Phone: (501) 812-4268
Fax: (501) 812-4286
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 964P | Arkansas |
Profile Details
| NPI number | 1710935218 |
|---|---|
| LBN Legal business name | Ekdahl, Mary Moore |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Mar 8th, 2013 - about 11 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 | 1710935218 | NPPES |
| Arkansas | MEDICAID | 139320719 |
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