Provider Demographics
NPI:1992821508
Name:DILLINGER, RELLIA ANN (ED,S, LPC)
Entity type:Individual
Prefix:MRS
First Name:RELLIA
Middle Name:ANN
Last Name:DILLINGER
Suffix:
Gender:F
Credentials:ED,S, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 870
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72203-0870
Mailing Address - Country:US
Mailing Address - Phone:501-244-9950
Mailing Address - Fax:501-372-9600
Practice Address - Street 1:820 W 6TH ST
Practice Address - Street 2:STE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201
Practice Address - Country:US
Practice Address - Phone:501-244-9950
Practice Address - Fax:501-372-9600
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8008079101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
24029OtherNAT'L SCHOOL PSYCH CERT