Healthcare Provider Details

I. General information

NPI: 1821912494
Provider Name (Legal Business Name): EMMA L GOODIN CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W PERRY RD
ROGERS AR
72758-6110
US

IV. Provider business mailing address

2100 W PERRY RD
ROGERS AR
72758-6110
US

V. Phone/Fax

Practice location:
  • Phone: 479-631-3515
  • Fax: 479-202-9105
Mailing address:
  • Phone: 479-636-3515
  • Fax: 479-202-9105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number203673
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: