Organization Name: | MW |
NPI Number: | 1508269341 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY WALLACE (CEO) |
Mailing Address: | 401 E South St Harrisburg |
State: | AR US |
Postal Code: | 724321927 |
Phone Number: | 8709260117 |
Fax Number: | |
NPI Enumeration Date: | 10/08/2014 |
NPI Last Update Date: | 10/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1978 |
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 |