Provider Demographics
NPI:1871316794
Name:EPTING, JAVONTE NIKKI
Entity type:Individual
Prefix:
First Name:JAVONTE
Middle Name:NIKKI
Last Name:EPTING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-3347
Mailing Address - Country:US
Mailing Address - Phone:501-328-3274
Mailing Address - Fax:
Practice Address - Street 1:1122 S 2ND ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3347
Practice Address - Country:US
Practice Address - Phone:501-328-3274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician