Wendy L. Clark, MSCCC-SLP

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

NPI 1710135504 · NPPES record last updated Sep 1, 2011

Key facts

NPI
1710135504
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1722 (AR)
Practice address
133 N Main St
Beebe, AR 72012-3045
Phone
(501) 882-3852
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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

State licenses

LicenseStateTypeSpecialty
1722ARMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wilbur Mills Early Childhood Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1722 AR Yes

Addresses

Primary practice location

133 N Main St
Beebe, AR 72012-3045

Mailing address

PO Box 850
Beebe, AR 72012-0850
Phone (501) 882-3852

Other identifiers

IdentifierTypeStateIssuer
140673721MedicaidAR

Other providers in Beebe, AR

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

Sources for this page

Verify at the official NPI Registry.