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Organization
EARLE SCHOOL DISTRICT
Active
Organization
EARLE SCHOOL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTIE IVY (SPEECH PATHOLOGIST)
(870) 792-8486
Entity
Organization
Contact information
Practice address
1401 3RD ST, EARLE, AR 72331-1353
(870) 792-8486
(980) 792-8897
Mailing address
1401 3RD ST, P.O. BOX 637, EARLE, AR 72331-1353
(870) 792-8486
(980) 792-8897
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 822
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183723743
—
AR
Enumeration date
05/18/2007
Last updated
01/12/2011
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