Healthcare Provider Details

I. General information

NPI: 1467119669
Provider Name (Legal Business Name): SARAH SHIELDS SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 S SILVER ST
SILOAM SPRINGS AR
72761-4152
US

IV. Provider business mailing address

2609 S SILVER ST
SILOAM SPRINGS AR
72761-4152
US

V. Phone/Fax

Practice location:
  • Phone: 707-479-8590
  • Fax:
Mailing address:
  • Phone: 707-479-8590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number203463
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3304
License Number StateND
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: