Doctor Name: | BECKY MITCHUM |
NPI Number: | 1275913196 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SP#3748 |
Business Practice Address: | 304 Sorenson St North Little Rock, AR - 721183473 |
Business Phone Number: | 5012465191 |
Business Fax Number: | |
Mailing Address: | 18 Masters Place Dr, MAUMELLE |
State: | AR |
Postal Code: | 721137019 |
Phone Number: | 5015903138 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2015 |
NPI Last Update Date: | 06/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP#3748 |
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 |