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NPI Code Detail

MEDICARE: SAMANTHA DEE MCDONALD SLP

MEDICARE: SAMANTHA DEE MCDONALD 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
12355S0801XSpeech-Language Assistant201337AR
2235Z00000XSpeech-Language Pathologist201408AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295326312
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA DEE MCDONALD SLP
Provider Business Mailing Address
First Line : 314 S 17TH ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-3836
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6205 ATLANTA ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4921
Country : US
Telephone Number : 918-208-3279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2021
Last Update Date : 03/24/2024

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Directions to “ SAMANTHA DEE MCDONALD SLP” Practice Location

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