Individual
MRS. MARY QUIN RABREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3162 M.L.K. JR BLVD STE 4, FAYETTEVILLE, AR 72704-4741
(479) 435-6636
Mailing address
13584 MCALPIN RD, FAYETTEVILLE, AR 72704-4741
(479) 684-8191
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
201556
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194499608
—
AR
Enumeration date
08/07/2021
Last updated
07/14/2023
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