Healthcare Provider Details

I. General information

NPI: 1760541262
Provider Name (Legal Business Name): DANA RUDDER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 ALBERT PIKE RD
HOT SPRINGS AR
71913-4134
US

IV. Provider business mailing address

600 PITTMAN RD
HOT SPRINGS AR
71913-9073
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-3606
  • Fax: 501-318-0383
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number891
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: