Doctor Name: | MRS. CORRI BETH CHISM |
NPI Number: | 1215150719 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CF SLP |
License Number: | SP#2452 |
Business Practice Address: | 1301 Russell Road Russellville, AR - 72801 |
Business Phone Number: | 4799672322 |
Business Fax Number: | 4799672876 |
Mailing Address: | Po Drawer 2109, RUSSELLVILL |
State: | AR |
Postal Code: | 72811 |
Phone Number: | 4799672322 |
Fax Number: | |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 03/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP#2452 |
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 |