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General NPI Number Information
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NPI Number | 1366117475
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Entity Type | Individual
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Provider Name | SKYLER PHELPS M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 17706 I 30
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City | BENTON
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State | AR
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Zip | 72019-2907
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Country | US
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Telephone | 501-315-4414
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Fax |
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Provider Business Mailing Address
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Address Line | 429 WISTERIA DR
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City | BAUXITE
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State | AR
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Zip | 72011-8932
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Country | US
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Telephone | 870-308-0047
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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 |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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