Doctor Name: | MRS. VANESSA YVONNE BOOMER |
NPI Number: | 1164694147 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SP2260 |
Business Practice Address: | 420 N West End St Springdale, AR - 727643002 |
Business Phone Number: | 4797508859 |
Business Fax Number: | |
Mailing Address: | 727 Almoo St, LOWELL |
State: | AR |
Postal Code: | 727459545 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/30/2008 |
NPI Last Update Date: | 03/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP2260 |
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 |