Basic Information
| Provider Information | |||||||||
| NPI: | 1578754628 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUFFINGTON | ||||||||
| FirstName: | TENETHREA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 CORPORATE HILL DR | ||||||||
| Address2: | SUITE #330 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722054540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5019547470 | ||||||||
| FaxNumber: | 5019547420 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 CORPORATE HILL DR | ||||||||
| Address2: | SUITE #330 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722054540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5019547470 | ||||||||
| FaxNumber: | 5019547420 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 10/08/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | A0609053 | AR | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | P0909056 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.