Provider Demographics
NPI:1134437676
Name:PINKSTON, DEBORAH ANN (PHD, LAC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:PINKSTON
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 SE G ST STE 9
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3740
Mailing Address - Country:US
Mailing Address - Phone:479-855-5704
Mailing Address - Fax:
Practice Address - Street 1:2705 SE G ST STE 9
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3740
Practice Address - Country:US
Practice Address - Phone:479-855-5704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1008091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health