Healthcare Provider Details

I. General information

NPI: 1538794367
Provider Name (Legal Business Name): ANDREA DAWN POINTER M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 FAYETTEVILLE RD
VAN BUREN AR
72956-3363
US

IV. Provider business mailing address

1109 FAYETTEVILLE RD
VAN BUREN AR
72956-3363
US

V. Phone/Fax

Practice location:
  • Phone: 479-474-6444
  • Fax:
Mailing address:
  • Phone: 479-474-6444
  • 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:
Title or Position:
Credential:
Phone: