Doctor Name: | DEEDRA A BRANSCUM |
NPI Number: | 1487860904 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | SP#1654 |
Business Practice Address: | 2403 Marylane Dr Rogers, AR - 727566702 |
Business Phone Number: | 4797907979 |
Business Fax Number: | 4796318993 |
Mailing Address: | 2403 Marylane Dr, ROGERS |
State: | AR |
Postal Code: | 727566702 |
Phone Number: | 4797907979 |
Fax Number: | 4796318993 |
NPI Enumeration Date: | 05/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP#1654 |
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 |