Individual
MRS. BRANDI WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
112 SOUTH 5TH ST., HERBER SPRINGS, AR 72543-3816
(501) 547-9994
(888) 898-8972
Mailing address
112 SOUTH 5TH ST, HEBER SPRINGS, AR 72543-3816
(501) 250-5166
(888) 898-8972
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#2056
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175067721
—
AR
Enumeration date
02/11/2009
Last updated
10/06/2020
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