Individual
ARLA FANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
403 PINE ST, BOX A, CALLAO, MO 63534-0205
(660) 768-5541
(660) 768-5699
Mailing address
1718 STRATFORD DR, MACON, MO 63552-1962
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
019235
MO
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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