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General NPI Number Information
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NPI Number | 1821325358
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Entity Type | Individual
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Provider Name | JESSICA LYNN WHITE M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 401 N LINCOLN ST
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City | CABOT
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State | AR
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Zip | 72023-2625
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Country | US
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Telephone | 501-944-5350
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Fax |
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Provider Business Mailing Address
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Address Line | 3811 N OLIVE ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-8747
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Country | US
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Telephone |
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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#P8259
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License Number State | AR
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