Doctor Name: | KORDELIA STEWART-HURST |
NPI Number: | 1629299201 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSCCCSLP |
License Number: | SP1250 |
Business Practice Address: | 2705 Se G Street, Suite 1 Bentonville, AR - 72712 |
Business Phone Number: | 4792732345 |
Business Fax Number: | 4792739391 |
Mailing Address: | P.o. Box 585, PEA RIDGE |
State: | AR |
Postal Code: | 72751 |
Phone Number: | 4792732345 |
Fax Number: | 4792732345 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP1250 |
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 |