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Individual

MALLARY BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1699 RED WOLF BLVD STE H, JONESBORO, AR 72401-5453
(870) 336-0021
(870) 336-0021
Mailing address
3505 WESTERN GALES DR, JONESBORO, AR 72401-9197
(870) 316-0789

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
17-007
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLPA
SPEECH ASSISTANT
AR
Enumeration date
06/20/2017
Last updated
06/20/2017
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