| Doctor Name: | MR. CLINTON LOWELL RICKETT |
| NPI Number: | 1376692830 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S.-CCC-SLP |
| License Number: | SP#2022 |
| Business Practice Address: | 167 South Spur 8 Glenwood, AR - 71943 |
| Business Phone Number: | 8703563622 |
| Business Fax Number: | 8703563623 |
| Mailing Address: | 107 Caraway St, PEARCY |
| State: | AR |
| Postal Code: | 719649732 |
| Phone Number: | 5017675563 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP#2022 |
| 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 |