| Kati M Street, Phd, Pllc | |
|
31 E Center St Ste 209 Fayetteville AR 72701-5391 | |
| (479) 222-1041 | |
| (910) 713-1288 |
| Full Name | Kati M Street, Phd, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 31 E Center St Ste 209, Fayetteville, Arkansas |
| Authorized Official Name and Position | Kati Street (MANAGER/OWNER) |
| Authorized Official Contact | 4792221041 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kati M Street, Phd, Pllc 31 E Center St Ste 209 Fayetteville AR 72701-5391 Ph: (479) 222-1041 | Kati M Street, Phd, Pllc 31 E Center St Ste 209 Fayetteville AR 72701-5391 Ph: (479) 222-1041 |
| NPI Number | 1093509333 |
|---|---|
| Provider Enumeration Date | 04/09/2025 |
| Last Update Date | 04/09/2025 |
| Certification Date | 04/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093509333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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