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Individual

MRS. KASIE YVONNE BIRDWELL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MS CCC SLP

Contact information

Practice address
17706 I30, STE 3, BENTON, AR 72015
(501) 315-4414
(501) 315-3467
Mailing address
17706 I30, STE 3, BENTON, AR 72015
(501) 315-4414
(501) 315-3467

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2201
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5Y067
BCBS
AR
Enumeration date
03/21/2006
Last updated
07/08/2007
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