Fitzgerald, Denise Mary

Fitzgerald, Denise Mary is an individual health care provider with primary practice located at 2205 Phyllis St , Bentonville AR 72712-6490. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fitzgerald, Denise Mary can be contacted via phone (479) 750-2020.

Contact Information

Primary practice address
2205 Phyllis St Bentonville AR 72712-6490
Phone: (479) 750-2020
Fax: (479) 845-2109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1761-C Arkansas

Profile Details

NPI number 1669415139
LBN Legal business name Fitzgerald, Denise Mary
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Jul 8th, 2007 - about 19 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 1669415139 NPPES
Arkansas Other 5X504 BLUE SHIELD PROVIDER #

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