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NPI Code Detail

MEDICARE: ELIZABETH ADELE LEDBETTER MSSLP

MEDICARE: ELIZABETH ADELE LEDBETTER MSSLP
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
1235Z00000XSpeech-Language PathologistSP#P8156AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SP#P8156OTHERARARKANSAS BOARD OF EXAMINERS SPEEC-LANGUAGE PATHOLOGY AND AUDIO

General Provider Information

NPI Number : 1497907653
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ADELE LEDBETTER MSSLP
Provider Business Mailing Address
First Line : 2510 W HUDSON RD
Second Line :
City : ROGERS
State : AR
Zip : 72756-2072
Country : US
Telephone Number : 479-936-1061
Fax Number :
Provider Business Practice Location Address
First Line : 2510 W HUDSON RD
Second Line :
City : ROGERS
State : AR
Zip : 72756-2072
Country : US
Telephone Number : 479-936-1061
Fax Number : 855-812-1132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2008
Last Update Date : 12/20/2021

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Directions to “ ELIZABETH ADELE LEDBETTER MSSLP” Practice Location

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