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General NPI Number Information
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NPI Number | 1760797831
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Entity Type | Individual
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Provider Name | RACHEL ELIZABETH GLADE SLP, LSLS CERT. AVT
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Gender | Female
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 606 N. RAZORBACK ROAD UA SPEECH & HEARING CLINIC
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City | FAYETTEVILLE
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State | AR
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Zip | 72701
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Country | US
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Telephone | 479-575-3575
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Fax | 479-575-4507
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Provider Business Mailing Address
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Address Line | 606 N. RAZORBACK ROAD UA SPEECH & HEARING CLINIC
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City | FAYETTEVILLE
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State | AR
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Zip | 72701
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Country | US
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Telephone | 479-575-3575
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Fax | 479-575-4507
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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#P8329
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License Number State | AR
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