| Broken Crayons, LLC | |
|
309 S Missouri St Pine Bluff AR 71601-4470 | |
| (870) 395-0385 | |
| Not Available |
| Full Name | Broken Crayons, LLC |
|---|---|
| Speciality | Counselor - Professional |
| Location | 309 S Missouri St, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Porsha Mcdonald (MANAGING MEMBER) |
| Authorized Official Contact | 8703950385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broken Crayons, LLC 309 S Missouri St Pine Bluff AR 71601-4470 Ph: (870) 395-0385 | Broken Crayons, LLC 309 S Missouri St Pine Bluff AR 71601-4470 Ph: (870) 395-0385 |
| NPI Number | 1437883774 |
|---|---|
| Provider Enumeration Date | 07/12/2022 |
| Last Update Date | 07/12/2022 |
| Certification Date | 07/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437883774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Primary |
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