Healthcare Provider Details

I. General information

NPI: 1508024803
Provider Name (Legal Business Name): ANGELIA D JOSLIN M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3068 ED HAYMES RD
AUSTIN AR
72007-9511
US

IV. Provider business mailing address

3068 ED HAYMES RD
AUSTIN AR
72007-9511
US

V. Phone/Fax

Practice location:
  • Phone: 501-605-1439
  • Fax:
Mailing address:
  • Phone: 501-605-1439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP#1906
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: