Connie Runyan

Individual provider Active NPI Speech-Language Pathologist · Bismarck, AR

NPI 1063672996 · NPPES record last updated Jun 13, 2008

Key facts

NPI
1063672996
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
11636 Highway 84
Bismarck, AR 71929-7473
Phone
(501) 865-4506
Fax
(501) 865-4545
NPI assigned
Jun 13, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X AR Yes

Addresses

Primary practice location

11636 Highway 84
Bismarck, AR 71929-7473

Mailing address

11636 Highway 84
Bismarck, AR 71929-7473
Phone (501) 865-4506

Other providers in Bismarck, AR

All providers in Bismarck, AR · Speech-Language Pathologist in Arkansas

Sources for this page

Verify at the official NPI Registry.