NPI 1003225301
Brenton Paul Ezell, LCSW
Practice location
- Address
- 111 S 3rd Ave, Piggott, AR 72454-2634
- Phone
- (870) 598-0306
- Fax
- (870) 598-0328
- Mailing address
- 1815 Pleasant Grove Rd, Jonesboro, AR 72405-7870
Registered specialties (3)
Clinical Social Worker
Primary
Case Manager/Care Coordinator
Case Manager/Care Coordinator
Registry record
- NPI
- 1003225301
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 12 Aug 2014
- Record last updated
- 29 Nov 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.