Individual
MARY BETH STIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 WILSON LOOP RD, WARD, AR 72176
(501) 941-5630
Mailing address
28 WILLOW DR, CABOT, AR 72023-3839
(501) 605-7491
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
880
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U838
BLUE CROSS BLUE SHIELD
AR
Enumeration date
01/31/2007
Last updated
07/08/2007
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