Provider Demographics
NPI:1760087902
Name:COMPREHENSIVE HEALTH PSYCHOLOGY & TESTING
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTH PSYCHOLOGY & TESTING
Other - Org Name:COMPREHENSIVE HEALTH PSYCHOLOGY & TESTING, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:501-271-8121
Mailing Address - Street 1:3101 CLUB MANOR DR STE A
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6088
Mailing Address - Country:US
Mailing Address - Phone:501-271-8121
Mailing Address - Fax:866-573-0780
Practice Address - Street 1:3101 CLUB MANOR DR STE A
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6088
Practice Address - Country:US
Practice Address - Phone:501-271-8121
Practice Address - Fax:866-573-0780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty