Healthcare Provider Details
I. General information
NPI: 1356279566
Provider Name (Legal Business Name): ANNABELLE DYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
233 S TREATING PLANT RD
DE QUEEN AR
71832-2909
US
IV. Provider business mailing address
1200 COVINGTON WAY APT 2712
CONWAY AR
72034-0139
US
V. Phone/Fax
- Phone: 870-584-4311
- Fax:
- Phone: 870-582-3764
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2355S0801X |
| Taxonomy | Speech-Language Assistant |
| License Number | |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: