Dana Renee Devereux, MCD, CCC-SLP

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

NPI 1508912437 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1508912437
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP#1569 (AR)
Practice address
1005 Balcom LN
Trumann, AR 72472-9502
Phone
(870) 483-1461
Fax
(870) 483-6520
NPI assigned
Jan 25, 2007
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

State licenses

LicenseStateTypeSpecialty
SP#1569ARMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP#1569 AR Yes

Addresses

Primary practice location

1005 Balcom LN
Trumann, AR 72472-9502

Mailing address

4312 Cypress Springs Rd
Jonesboro, AR 72401-8508
Phone (870) 802-2565

Other providers in Trumann, AR

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

Sources for this page

Verify at the official NPI Registry.