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General NPI Number Information
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NPI Number | 1134303670
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Entity Type | Individual
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Provider Name | AMANDA GUNN ZRAICK M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 1500 S PARK ST
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City | LITTLE ROCK
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State | AR
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Zip | 72202-5843
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Country | US
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Telephone | 501-447-1587
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Fax | 501-447-1401
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Provider Business Mailing Address
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Address Line | 1500 S PARK ST
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City | LITTLE ROCK
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State | AR
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Zip | 72202-5843
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Country | US
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Telephone | 501-447-1587
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Fax | 501-447-1401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP#1692
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License Number State | AR
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