Doctor Name: | MS. MARY ELLEN GARDNER |
NPI Number: | 1760689236 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSE-CD, CCC-SLP |
License Number: | 442 |
Business Practice Address: | 320 Sycamore St Augusta, AR - 720062650 |
Business Phone Number: | 8703472241 |
Business Fax Number: | |
Mailing Address: | 4317 Glenmere Rd, NORTH LITTLE ROCK |
State: | AR |
Postal Code: | 721167442 |
Phone Number: | 5014990275 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2007 |
NPI Last Update Date: | 08/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 442 |
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 |