Healthcare Provider Details

I. General information

NPI: 1588820831
Provider Name (Legal Business Name): SHERI KAYE REEVES M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2008
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3005 APACHE DR
JONESBORO AR
72401-7432
US

IV. Provider business mailing address

4216 CLUBHOUSE DR
JONESBORO AR
72405-8078
US

V. Phone/Fax

Practice location:
  • Phone: 870-336-0238
  • Fax: 870-336-0239
Mailing address:
  • Phone: 417-327-2278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number200986
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2000159282
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: