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NPI Code Detail

MEDICARE: EMILY K HENSON M.S., CCC-SLP

MEDICARE: EMILY K HENSON M.S., 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
1235Z00000XSpeech-Language Pathologist4194AR

General Provider Information

NPI Number : 1629546049
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY K HENSON M.S., CCC-SLP
Provider Business Mailing Address
First Line : 56 SPRINGRIDGE DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-5430
Country : US
Telephone Number : 816-785-9626
Fax Number :
Provider Business Practice Location Address
First Line : 8701 RILEY DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-6509
Country : US
Telephone Number : 501-224-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2018
Last Update Date : 11/03/2018

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