Individual
MRS. SHAY M FORTUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
4207 LONGTREE CV, LITTLE ROCK, AR 72212-1909
(501) 350-1008
Mailing address
4207 LONGTREE CV, LITTLE ROCK, AR 72212-1909
(501) 350-1008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1398
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135061721
—
AR
Enumeration date
09/29/2014
Last updated
09/29/2014
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