Healthcare Provider Details

I. General information

NPI: 1457490658
Provider Name (Legal Business Name): CAVE CITY SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N MAIN ST
CAVE CITY AR
72521-9103
US

IV. Provider business mailing address

711 N MAIN ST PO BOX 600
CAVE CITY AR
72521-9103
US

V. Phone/Fax

Practice location:
  • Phone: 870-283-5391
  • Fax:
Mailing address:
  • Phone: 870-283-5391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateAR

VIII. Authorized Official

Name: MS. MELISSA ANN HATFIELD
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MCD, CCC-SLP
Phone: 870-612-0827