Doctor Name: | MRS. BREA ANN BENNETT |
NPI Number: | 1386819134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP, M.S. CCC-SLP |
License Number: | SP#2467 |
Business Practice Address: | 406 Nw 2nd St Bentonville, AR - 727125238 |
Business Phone Number: | 4792545440 |
Business Fax Number: | |
Mailing Address: | 406 Nw 2nd St, BENTONVILLE |
State: | AR |
Postal Code: | 727125238 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/23/2008 |
NPI Last Update Date: | 04/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP#2467 |
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 |