Individual
TONYA GAMBILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S, CCC-SLP
Contact information
Practice address
1301 RUSSELL RD, RUSSELLVILLE, AR 72802-4320
(479) 967-2316
(479) 967-3639
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP# 2060
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156650721
—
AR
01
—
5X955
BLUE CROSS BLUE SHIELD #
AR
Enumeration date
02/25/2006
Last updated
01/06/2023
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