Healthcare Provider Details
I. General information
NPI: 1063985869
Provider Name (Legal Business Name): CADY HONEYCUTT SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/04/2019
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1630 HIGHWAY 91 W
JONESBORO AR
72404-9284
US
IV. Provider business mailing address
3005 APACHE DR
JONESBORO AR
72401-7432
US
V. Phone/Fax
- Phone: 870-935-7503
- Fax:
- Phone: 870-336-0238
- Fax: 870-336-0239
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 200397 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: