Provider Demographics
NPI:1447839899
Name:ROBLES, BRITTANY SELENE (QBHP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SELENE
Last Name:ROBLES
Suffix:
Gender:F
Credentials:QBHP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:SELENE
Other - Last Name:CARUSO/ESTRADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1815 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-7870
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-933-9395
Practice Address - Street 1:700 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-4445
Practice Address - Country:US
Practice Address - Phone:870-425-1041
Practice Address - Fax:870-425-1049
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARQBHP171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator