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Individual

BLAINE YARBROUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CCC-SLP

Contact information

Practice address
1100 DIVISION ST STE 3, PRAIRIE GROVE, AR 72753-5501
(479) 334-0014
(479) 334-0013
Mailing address
1100 DIVISION ST STE 3, PRAIRIE GROVE, AR 72753-5501
(479) 334-0014
(479) 334-0013

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000000000
HE DOES NOT HAVE ANY OTHER NUMBERS YET
Enumeration date
09/24/2021
Last updated
09/24/2021
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