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General NPI Number Information
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NPI Number | 1063022986
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Entity Type | Organization
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Legal Business Name | ADULT SPEECH AND VOICE CARE OF NORTHWEST ARKANSAS, LLC
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/09/2021
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Provider Practice Location Address
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Address Line | 1516 N CORSICA DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-6168
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Country | US
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Telephone | 479-358-7819
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 N CORSICA DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-6168
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Country | US
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Telephone | 479-358-7819
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST, OWNER
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Name | TORRY LYNN FARNELL
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Credential | M.S., CCC-SLP
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Telephone | 479-358-7819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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