Provider Demographics
NPI:1831897586
Name:ARKANSAS REPRODUCTIVE THERAPY, LC
Entity type:Organization
Organization Name:ARKANSAS REPRODUCTIVE THERAPY, LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:QUILLET
Authorized Official - Suffix:
Authorized Official - Credentials:MA LMFT
Authorized Official - Phone:615-861-9706
Mailing Address - Street 1:5507 RANCH DR STE 209B
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-0043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5507 RANCH DR STE 209B
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-0043
Practice Address - Country:US
Practice Address - Phone:615-861-9706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)