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General NPI Number Information
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NPI Number | 1265309199
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Entity Type | Individual
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Provider Name | GRACE MARIE DICKINSON MS CFY-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 11520 SR 27
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City | HECTOR
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State | AR
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Zip | 72843-8710
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Country | US
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Telephone | 479-284-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 DONNELL RIDGE RD APT 1209
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City | CONWAY
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State | AR
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Zip | 72034-8786
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Country | US
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Telephone | 479-970-9972
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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 |
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License Number State | AR
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