Amanda Mychale Coco

Individual provider Active NPI Speech-Language Pathologist · Pea Ridge, AR

NPI 1386891307 · NPPES record last updated Aug 21, 2008

Key facts

NPI
1386891307
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
781 W Pickens Rd
Pea Ridge, AR 72751-2519
Phone
(479) 451-8181
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pea Ridge School District Past Accepting new patients
Gentry Public School Past Accepting new patients
Gentry School District Past Accepting new patients

Specialties & licenses

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

Addresses

Primary practice location

781 W Pickens Rd
Pea Ridge, AR 72751-2519

Mailing address

201 S Giles Ave
Gentry, AR 72734-9320
Phone (479) 736-2253

Other providers in Pea Ridge, AR

All providers in Pea Ridge, AR · Speech-Language Pathologist in Arkansas

Sources for this page

Verify at the official NPI Registry.