Individual
MRS. CORRI BETH CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CF SLP
Contact information
Practice address
1301 RUSSELL ROAD, RUSSELLVILLE, AR 72801
(479) 967-2322
(479) 967-2876
Mailing address
PO DRAWER 2109, RUSSELLVILL, AR 72811
(479) 967-2322
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#2452
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A020
TRICARE
—
05
—
SP4297
—
AK
Enumeration date
04/11/2007
Last updated
03/06/2008
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