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General NPI Number Information
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NPI Number | 1720039381
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Entity Type | Individual
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Provider Name | JAYNA ELIZABETH WEBER M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 1004 SE 5TH ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-6032
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Country | US
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Telephone | 479-254-6717
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Fax |
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Provider Business Mailing Address
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Address Line | 2729 N WAKEFIELD PL
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4325
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Country | US
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Telephone | 479-841-7131
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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#2230
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License Number State | AR
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