Individual
ALISHA DRIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
21 W AUGUSTA DR APT 9, FAYETTEVILLE, AR 72703-4474
(501) 318-4558
Mailing address
21 W AUGUSTA DR APT 9, FAYETTEVILLE, AR 72703-4474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#2751
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204098721
—
AR
Enumeration date
04/14/2014
Last updated
06/13/2016
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