Healthcare Provider Details

I. General information

NPI: 1336079771
Provider Name (Legal Business Name): AMY WHITE ADULT SPEECH THERAPY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 W POPLAR ST UNIT 206
ROGERS AR
72756-4560
US

IV. Provider business mailing address

1412 PARK ST
LOWELL AR
72745-6028
US

V. Phone/Fax

Practice location:
  • Phone: 479-363-1788
  • Fax:
Mailing address:
  • Phone: 479-379-2827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMY WHITE
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 479-379-2827