Individual
MRS. ABBIE ALICE BOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
272 SCHOOL AVE, WEST FORK, AR 72774-3124
(479) 839-3349
Mailing address
6208 W PERSIMMON ST, FAYETTEVILLE, AR 72704-7054
(870) 577-5854
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
P8269
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184101721
—
AR
Enumeration date
01/06/2010
Last updated
02/02/2023
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