Healthcare Provider Details

I. General information

NPI: 1578382644
Provider Name (Legal Business Name): SOPHIE STEPHENSON MS, CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SOPHIE QUICK

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E 9TH ST
MOUNTAIN HOME AR
72653-4704
US

IV. Provider business mailing address

PO BOX 2518
MOUNTAIN HOME AR
72654-2518
US

V. Phone/Fax

Practice location:
  • Phone: 870-404-5870
  • Fax: 870-424-3208
Mailing address:
  • Phone: 870-656-7440
  • Fax: 870-424-3208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number203555
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: