Healthcare Provider Details
I. General information
NPI: 1891452561
Provider Name (Legal Business Name): BRITTEN SPEARS BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/17/2021
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2911 LONGVIEW DR STE B
JONESBORO AR
72401-5902
US
IV. Provider business mailing address
12930 W SARDIS RD
BAUXITE AR
72011-9279
US
V. Phone/Fax
- Phone: 870-336-0238
- Fax: 870-336-0239
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2355S0801X |
| Taxonomy | Speech-Language Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 202278 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: