Individual
MADISON MITFORD PEMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 W POPLAR ST, ROGERS, AR 72756-4242
(479) 631-7678
Mailing address
1000 W POPLAR ST, ROGERS, AR 72756-4242
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
203194
AR
246Q00000X
Pathology Specialist/Technologist
117179
TX
Other
Enumeration date
08/18/2020
Last updated
08/05/2025
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