Individual
TARA STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
8 S BROADVIEW ST, GREENBRIER, AR 72058-9601
(501) 581-6045
Mailing address
PO BOX 933, GREENBRIER, AR 72058-0933
(501) 581-6045
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
P7988
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164775721
—
AR
Enumeration date
02/28/2008
Last updated
08/13/2008
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