Healthcare Provider Details

I. General information

NPI: 1053866103
Provider Name (Legal Business Name): DALEY GAMBLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3148 AR-367
CABOT AR
72023
US

IV. Provider business mailing address

3148 AR-367
CABOT AR
72023
US

V. Phone/Fax

Practice location:
  • Phone: 501-941-3500
  • Fax: 501-246-7919
Mailing address:
  • Phone: 501-941-3500
  • Fax: 501-246-7919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4230
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: