Healthcare Provider Details

I. General information

NPI: 1982963781
Provider Name (Legal Business Name): MISS CALLIE MONTANA EFIRD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CALLIE EFIRD

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 APACHE TRL
DE QUEEN AR
71832-9228
US

IV. Provider business mailing address

187 APACHE TRL
DE QUEEN AR
71832-9228
US

V. Phone/Fax

Practice location:
  • Phone: 870-584-7864
  • Fax:
Mailing address:
  • Phone: 870-584-7864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number251300000X
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: