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General NPI Number Information
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NPI Number | 1598036030
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Entity Type | Organization
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Legal Business Name | SPEECH WORKS, LLC
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 111 MERRIMAN AVE E
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City | WYNNE
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State | AR
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Zip | 72396-2941
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Country | US
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Telephone | 870-270-7963
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Fax | 870-697-2296
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Provider Business Mailing Address
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Address Line | 5 COUNTY ROAD 7290
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City | WYNNE
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State | AR
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Zip | 72396-8121
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Country | US
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Telephone | 870-270-7963
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Fax | 870-374-6061
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Authorized Official
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Title or Position | SLP
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Name | JAMIE L FREDERICK
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Credential |
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Telephone | 870-270-7963
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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#3079
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License Number State | AR
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