Healthcare Provider Details

I. General information

NPI: 1053534651
Provider Name (Legal Business Name): PATRICIA ANN MUNSON M.S.,CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 S SOWELL ST
SEARCY AR
72143-6356
US

IV. Provider business mailing address

2300 CHARLESTOWNE DR
SEARCY AR
72143-7024
US

V. Phone/Fax

Practice location:
  • Phone: 501-268-9227
  • Fax: 501-268-7734
Mailing address:
  • Phone: 501-268-1595
  • Fax: 501-268-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number633
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: