Male or Other

Nicholas Mitrani LPE-I

Clinical Psychologist in Conway, AR(View on Map)

Full Name

Nicholas Mitrani LPE-I

NPI Number

1629426770

NPI Type

Individual Provider

Gender

Male

Enumeration Date

05/31/2016

Specialties

(Taxonomies)

Code

103TC0700X
103TC2200X
103TC1900X
103T00000X

Primary Taxonomy

Yes
No
No
No

Licenses

State

Arkansas

License Number

18-22P

Contact
Information

Purpose

Mailing
Location

Address

4206 PRINCE STREET
4206 PRINCE STREET

City

Conway
Conway

State

AR
AR

Postal Code

72034-9398
72034-9398

Country

US
US

Telephone Number

(501) 932-0255
(501) 932-0255

Identifiers

Identifier

232944719

Identifier State

AR

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/24/2019

Provider Address

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