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General NPI Number Information
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NPI Number | 1851716005
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Entity Type | Organization
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Legal Business Name | STEPHANIE BUTCHER
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 3300 CLIFF DR
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City | FORT SMITH
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State | AR
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Zip | 72903-5917
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Country | US
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Telephone | 479-226-2805
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 CLIFF DR
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City | FORT SMITH
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State | AR
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Zip | 72903-5917
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Country | US
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Telephone | 479-226-2805
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Fax |
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Authorized Official
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Title or Position | SLP
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Name | STEPHANIE BUTCHER
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Credential | MS, CCC-SLP
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Telephone | 479-226-2805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | SP# 2563
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License Number State | AR
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