Provider Demographics
NPI:1679029201
Name:BOKKER, ARIC
Entity Type:Individual
Prefix:
First Name:ARIC
Middle Name:
Last Name:BOKKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72525-0176
Mailing Address - Country:US
Mailing Address - Phone:870-257-3336
Mailing Address - Fax:870-257-3339
Practice Address - Street 1:2012 HIGHWAY 62 412
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:AR
Practice Address - Zip Code:72542-9477
Practice Address - Country:US
Practice Address - Phone:870-856-3337
Practice Address - Fax:870-856-3334
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1901006101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health