Individual
DENISE PAXTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 SOLITUDE DR, VAN BUREN, AR 72956-9037
(479) 414-0090
Mailing address
1104 SOLITUDE DR, VAN BUREN, AR 72956-9037
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7358
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100651670A
—
OK
05
—
138541721
—
AR
01
—
5U525
BCBS
AR
Enumeration date
04/02/2006
Last updated
02/17/2009
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