Individual
JACOB LEE OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
719 DETROIT AVE, DANVILLE, AR 72833-9607
(479) 495-6252
Mailing address
PO BOX 639, DANVILLE, AR 72833-0639
(479) 495-6252
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
200110
AR
Other
Enumeration date
06/08/2020
Last updated
06/08/2020
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