Southard, Jamie

Southard, Jamie is an individual health care provider with primary practice located at 4101 Angelus St , Paragould AR 72450-2523. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Southard, Jamie can be contacted via phone (870) 568-5195.

Contact Information

Primary practice address
4101 Angelus St Paragould AR 72450-2523
Phone: (870) 568-5195
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1144868845
LBN Legal business name Southard, Jamie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2019
Last updated Jan 23rd, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144868845 NPPES
Other RBT-20-127397 BACB
MEDICAID 236430795 BACB

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