Young, Myrna Borbon

Young, Myrna Borbon is an sole proprietor health care provider with primary practice located at 130 E Poplar St Ste C&D , Fayetteville AR 72703. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Young, Myrna Borbon can be contacted via phone (479) 435-6047.

Contact Information

Primary practice address
130 E Poplar St Ste C&D Fayetteville AR 72703
Phone: (479) 435-6047
Fax: (479) 755-3595
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X A0507049 Arkansas
Behavioral Health & Social Service Providers / Mental Health 101YM0800X P0807060 Arkansas
Behavioral Health & Social Service Providers / Professional 101YP2500X P0807060 Arkansas

Profile Details

NPI number 1487693891
LBN Legal business name Young, Myrna Borbon
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 5th, 2006
Last updated May 29th, 2018 - about 8 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 1487693891 NPPES
Arkansas MEDICAID 207210719

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