Provider Demographics
NPI:1316152952
Name:BIRT, JANICE M (MHPP)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:M
Last Name:BIRT
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 SOUTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-7125
Mailing Address - Country:US
Mailing Address - Phone:501-562-0514
Mailing Address - Fax:
Practice Address - Street 1:2 INNWOOD CIR
Practice Address - Street 2:SUITE A
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2447
Practice Address - Country:US
Practice Address - Phone:501-954-7470
Practice Address - Fax:501-954-7420
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health