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General NPI Number Information
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NPI Number | 1730266735
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Entity Type | Individual
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Provider Name | KATHLEEN MONIQUE WINTERS M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 9000 N RODNEY PARHAM RD
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City | LITTLE ROCK
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State | AR
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Zip | 72205-1646
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Country | US
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Telephone | 501-503-5160
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 RAHLING RD APT 1604
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City | LITTLE ROCK
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State | AR
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Zip | 72223-4669
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Country | US
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Telephone | 501-743-8398
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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 | 200336
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License Number State | AR
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