Eliza Adcock

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

NPI 1265041545 · NPPES record last updated Nov 27, 2023

Key facts

NPI
1265041545
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
14308005
Practice address
814 Watkins St
Conway, AR 72034-5152
Phone
(601) 896-8354
NPI assigned
Jul 23, 2020
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
Group: 193400000X SINGLE SPECIALTY GROUP
235Z00000X 14308005 Yes

Addresses

Primary practice location

814 Watkins St
Conway, AR 72034-5152

Mailing address

814 Watkins St
Conway, AR 72034-5152
Phone (601) 896-8354

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL archford.org

Other providers in Conway, AR

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

Sources for this page

Verify at the official NPI Registry.