Healthcare Provider Details

I. General information

NPI: 1467379222
Provider Name (Legal Business Name): VICTORIA BARNES ROSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 DEAVER ST
SPRINGDALE AR
72764-5356
US

IV. Provider business mailing address

130 CEDAR ST APT 3105
CENTERTON AR
72719-5125
US

V. Phone/Fax

Practice location:
  • Phone: 479-259-2339
  • Fax: 479-751-4000
Mailing address:
  • Phone: 479-259-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: