NPIMap

Jennifer Wiseman Humphries, M.S., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Calico Rock, AR

NPI 1154546844 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154546844
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP1245 (AR)
Practice address
301 College St
Calico Rock, AR 72519-0220
Phone
(870) 297-8533
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP1245ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Superintendent of Calico Rock High School Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1245 AR Yes

Addresses

Primary practice location

301 College St
Calico Rock, AR 72519-0220

Mailing address

301 College St
Calico Rock, AR 72519-0220
Phone (870) 297-8533

Other providers in Calico Rock, AR

All providers in Calico Rock, AR · Speech-Language Pathologist in Arkansas

Sources for this page

Verify at the official NPI Registry.