Most Relevant Information
Provider Data
| NPI Number: | 1003440249 |
| Provider Name: | CHALISA MAYO |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/26/2020 |
| Last Updated: | 02/26/2020 |
Provider Practice Location
6501 W 12TH ST
LITTLE ROCK
AR
722041511
Practice Location Phone/Fax
| Phone: | 5016668686 |
| Fax: |
Provider Mailing Location
PO BOX 251970
LITTLE ROCK
AR
722251970
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |