Individual
KENNA JOE MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
146 LINWOOD DR, PARAGOULD, AR 72450-4077
(870) 520-8761
Mailing address
146 LINWOOD DR, PARAGOULD, AR 72450
(870) 520-8761
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
201503
AR
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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