Individual
MRS. AMANDA R BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
10668 LYDIA LN, DANVILLE, AR 72833-6890
(479) 495-3626
(479) 495-6336
Mailing address
73 POPPY DR, POTTSVILLE, AR 72858-9202
(479) 567-5564
(479) 495-6336
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SPP8068
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169666721
—
AR
01
—
SPP8068
STATE LICENSE NUMBER
AR
Enumeration date
09/26/2008
Last updated
09/26/2008
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