Individual
MRS. AMY STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
719 N DETROIT, HIGHWAY 10 AT DETROIT, DANVILLE, AR 72833
(479) 495-6326
(479) 495-3336
Mailing address
10074 TATE LANE, DANVILLE, AR 72833
(479) 495-6326
(479) 495-3336
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1694
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12037270
AMERICAN ST, LANG, ASSOC
AR
01
—
5U922
BLUE CROSS ID NUMBER
AR
01
—
SP1694
STATE LICENSE NUMBER
AR
Enumeration date
04/20/2007
Last updated
07/09/2007
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