Healthcare Provider Details

I. General information

NPI: 1699899252
Provider Name (Legal Business Name): MELISSA HATFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 GRANGE RD
CAVE CITY AR
72521-9393
US

IV. Provider business mailing address

520 GRANGE RD
CAVE CITY AR
72521-9393
US

V. Phone/Fax

Practice location:
  • Phone: 870-612-0827
  • Fax: 870-994-3108
Mailing address:
  • Phone: 870-612-0827
  • Fax: 870-994-3108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1980
License Number StateAR

VIII. Authorized Official

Name: MELISSA ANN HATFIELD
Title or Position: OWNER
Credential: MCD, CCC-SLP
Phone: 870-612-0827