MEDICARE: MS. VALERIE PEARSALL M.ED.

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#454	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

General Provider Information

NPI Number	:	1861641979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VALERIE PEARSALL M.ED.

Provider Business Mailing Address
First Line	:	4015 STANNUS ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72204-7067
Country	:	US
Telephone Number	:	501-447-7236
Fax Number	:	501-447-7201

Provider Business Practice Location Address
First Line	:	4015 STANNUS ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72204-7067
Country	:	US
Telephone Number	:	501-447-7236
Fax Number	:	501-447-7201

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

Provider Enumeration Date	:	09/12/2008
Last Update Date	:	09/12/2008

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Directions to “ MS. VALERIE PEARSALL M.ED.” Practice Location

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