MEDICARE: MRS. TRICIA LYNNETTE GEORGE MS,CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP#1969	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1639440324	OTHER	AR	NPI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154544542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TRICIA LYNNETTE GEORGE MS,CCC-SLP

Provider Business Mailing Address
First Line	:	27104 PINE BLUFF LN
Second Line	:
City	:	GOLDEN
State	:	MO
Zip	:	65658-8381
Country	:	US
Telephone Number	:	870-715-5359
Fax Number	:	870-505-2016

Provider Business Practice Location Address
First Line	:	916 GOBLIN DR
Second Line	:
City	:	HARRISON
State	:	AR
Zip	:	72601-8885
Country	:	US
Telephone Number	:	870-654-3869
Fax Number	:	870-505-2016

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	03/11/2026

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Directions to “ MRS. TRICIA LYNNETTE GEORGE MS,CCC-SLP” Practice Location

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