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Individual

MRS. SAMANTHA JO DUBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BA, SLPA

Contact information

Practice address
1700 COMMERCE BLVD., NEWPORT, AR 72112-2445
(870) 995-5089
Mailing address
2109 NORMANDY DR, NEWPORT, AR 72112-2445
(870) 995-5089

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
11-003
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
187291721
AR
Enumeration date
08/10/2011
Last updated
02/02/2015
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