Healthcare Provider Details

I. General information

NPI: 1275561664
Provider Name (Legal Business Name): ROXANN OWEN S.L.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 HUNTINGTON RD
LITTLE ROCK AR
72227-2323
US

IV. Provider business mailing address

26 HUNTINGTON RD
LITTLE ROCK AR
72227-2323
US

V. Phone/Fax

Practice location:
  • Phone: 501-224-3451
  • Fax:
Mailing address:
  • Phone: 501-224-3451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1523
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: