Healthcare Provider Details

I. General information

NPI: 1598387037
Provider Name (Legal Business Name): ANNE-ASHLEY HULL M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12905 RANDOLPH ROAD
FAYETTEVILLE AR
72704
US

IV. Provider business mailing address

12905 RANDOLPH ROAD
FAYETTEVILLE AR
72704
US

V. Phone/Fax

Practice location:
  • Phone: 479-381-7860
  • Fax:
Mailing address:
  • Phone: 479-381-7860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: