Healthcare Provider Details
I. General information
NPI: 1932343381
Provider Name (Legal Business Name): ANN DENNISE BARROW MCD,CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/29/2009
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3920 WOODLAND HEIGHTS RD
LITTLE ROCK AR
72212-2495
US
IV. Provider business mailing address
20703 RIVER VISTA CIR
ROLAND AR
72135-9386
US
V. Phone/Fax
- Phone: 501-227-3600
- Fax: 501-227-3601
- Phone: 804-433-5606
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 1244 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: