Most Relevant Information
Provider Data
| NPI Number: | 1003695925 |
| Provider Name: | FANTASIA CANIYA NAKI BARMORE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/28/2023 |
| Last Updated: | 09/28/2023 |
Provider Practice Location
2740 COLLEGE AVE
CONWAY
AR
720346141
Practice Location Phone/Fax
| Phone: | 5013295459 |
| Fax: |
Provider Mailing Location
2740 COLLEGE AVE
CONWAY
AR
720346141
Provider Mailing Phone/Fax
| Phone: | 5013295459 |
| Fax: |