Healthcare Provider Details

I. General information

NPI: 1134422454
Provider Name (Legal Business Name): DANA AULGUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 12/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 SOUTH 'B' STREET
POTTSVILLE AR
72858-8721
US

IV. Provider business mailing address

87 SOUTH 'B' STREET
POTTSVILLE AR
72858-8721
US

V. Phone/Fax

Practice location:
  • Phone: 479-968-2133
  • Fax: 479-968-7672
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP736
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: