Healthcare Provider Details

I. General information

NPI: 1730646753
Provider Name (Legal Business Name): ABIGAIL KATHRYN MCGUIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 HIGHWAY 22 E STE A
BRANCH AR
72928-9648
US

IV. Provider business mailing address

3010 HIGHWAY 22 E STE A
BRANCH AR
72928-9648
US

V. Phone/Fax

Practice location:
  • Phone: 479-965-2191
  • Fax: 479-965-2723
Mailing address:
  • Phone: 479-965-2191
  • Fax: 479-965-2723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: