Individual
MOLLY ROAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 S LINCOLN ST STE A, LOWELL, AR 72745-9722
(479) 770-0744
(479) 770-0176
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215983721
—
AR
Enumeration date
04/27/2016
Last updated
01/10/2023
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