Mallory Hyatt

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

NPI 1487062279 · NPPES record last updated Dec 19, 2016

Key facts

NPI
1487062279
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP#P8791 (AR)
Practice address
101 Court St
Dumas, AR 71639-2214
Phone
(870) 382-4954
NPI assigned
Jul 24, 2014
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)
Yes

State licenses

LicenseStateTypeSpecialty
SP#P8791ARMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP#P8791 AR Yes

Addresses

Primary practice location

101 Court St
Dumas, AR 71639-2214

Mailing address

101 Court St
Dumas, AR 71639-2214

Other providers in Dumas, AR

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

Sources for this page

Verify at the official NPI Registry.