Individual
BECKY MITCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
304 SORENSON ST, NORTH LITTLE ROCK, AR 72118-3473
(501) 246-5191
Mailing address
18 MASTERS PLACE DR, MAUMELLE, AR 72113-7019
(501) 590-3138
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#3748
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206659721
—
AR
Enumeration date
06/05/2015
Last updated
06/05/2015
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