Most Relevant Information
Provider Data
| NPI Number: | 1003374943 |
| Provider Name: | ADAWNDA J MINNIE BA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/11/2019 |
| Last Updated: | 03/11/2019 |
Provider Practice Location
1801 CAVANAUGH RD LOT 37
FORT SMITH
AR
729087758
Practice Location Phone/Fax
| Phone: | 4796532513 |
| Fax: |
Provider Mailing Location
1801 CAVANAUGH RD LOT 37
FORT SMITH
AR
729087758
Provider Mailing Phone/Fax
| Phone: | 4796532513 |
| Fax: |