Healthcare Provider Details
I. General information
NPI: 1225475312
Provider Name (Legal Business Name): BRANDI PIPPIN HURTADO SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/29/2013
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 WOLFE ST
LITTLE ROCK AR
72202-5320
US
IV. Provider business mailing address
4301 W MARKHAM ST # 783
LITTLE ROCK AR
72205-7101
US
V. Phone/Fax
- Phone: 501-372-2768
- Fax: 501-978-6492
- Phone: 501-686-8000
- Fax: 501-526-5148
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SP3461 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: