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General NPI Number Information
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NPI Number | 1174799407
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Entity Type | Individual
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Provider Name | CORINNE ELDRIDGE M.C.D., CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 400 W LYNN ST
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City | BRINKLEY
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State | AR
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Zip | 72021-3405
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Country | US
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Telephone | 870-734-5010
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Fax | 870-734-5014
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Provider Business Mailing Address
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Address Line | 665 KNIGHT ST
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City | FORREST CITY
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State | AR
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Zip | 72335-3349
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Country | US
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Telephone | 870-633-8377
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Fax |
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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 | SP#1001
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License Number State | AR
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