Stephanie Anderson, MCD,CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Walnut Ridge, AR
NPI 1285892166 · NPPES record last updated May 28, 2008
Key facts
- NPI
- 1285892166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP#1965 (AR)
- Practice address
- 211 W Hickory St
Walnut Ridge, AR 72476-2648 - Phone
- (870) 886-3212
- Fax
- (870) 886-3224
- NPI assigned
- May 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP#1965 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Arkansas Educational Cooperative | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#1965 | AR | Yes |
Addresses
Primary practice location
211 W Hickory St
Walnut Ridge, AR 72476-2648
Mailing address
102 Savannah Cir
Walnut Ridge, AR 72476-8554
Phone (870) 897-1609
Other providers in Walnut Ridge, AR
- 1St Choice Healthcare Inc
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- Stephanie Paige Alsup
- Andrews Family Dentistry, P.a.
- Jordan Andrews
- Robin Diana Baltz
- Lauren Becker
- Jennifer Beggs
All providers in Walnut Ridge, AR · Speech-Language Pathologist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.