Healthcare Provider Details

I. General information

NPI: 1578785929
Provider Name (Legal Business Name): DAPHNE ELAINE CRIDER-WEST M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N MAIN ST
BEEBE AR
72012-3046
US

IV. Provider business mailing address

6504 WORTH AVE E
BENTON AR
72015-6668
US

V. Phone/Fax

Practice location:
  • Phone: 501-847-5675
  • Fax:
Mailing address:
  • Phone: 501-653-0983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number897
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: