Healthcare Provider Details

I. General information

NPI: 1720046485
Provider Name (Legal Business Name): EFFIE J HEULITT MS CCCSLP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: CANDY HEULITT

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6917 GEYER SPRINGS RD SUITE 1-S
LITTLE ROCK AR
72209
US

IV. Provider business mailing address

15 ALBAN LANE
LITTLE ROCK AR
72223
US

V. Phone/Fax

Practice location:
  • Phone: 501-570-4004
  • Fax: 501-570-4003
Mailing address:
  • Phone: 501-258-3155
  • Fax: 501-821-1968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP1209
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: