Individual
AUDREY MORTENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 BULLDOG DRIVE, PLUMERVILLE, AR 72127-8803
(501) 354-2269
Mailing address
101 BULLDOG DRIVE, PLUMERVILLE, AR 72127-8803
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8558
AR
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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