| Doctor Name: | KEM WEATHERSBY |
| NPI Number: | 1073679957 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | P7995 |
| Business Practice Address: | 8109 Interstate 30 Little Rock, AR - 722094840 |
| Business Phone Number: | 5015625400 |
| Business Fax Number: | |
| Mailing Address: | 2600 Apple Blossom Ln, CONWAY |
| State: | AR |
| Postal Code: | 720348490 |
| Phone Number: | 5015480169 |
| Fax Number: | |
| NPI Enumeration Date: | 12/28/2006 |
| NPI Last Update Date: | 11/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | P7995 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |