Healthcare Provider Details

I. General information

NPI: 1053549477
Provider Name (Legal Business Name): JESSICA FAYE HUFFTY MS, SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA FAYE WALSH

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3214 WINCHESTER
BENTON AR
72015-2929
US

IV. Provider business mailing address

17706 I-30 STE 3
BENTON AR
72019-2930
US

V. Phone/Fax

Practice location:
  • Phone: 501-315-4414
  • Fax: 501-315-3467
Mailing address:
  • Phone: 501-315-4414
  • Fax: 501-315-3467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: