Individual
AMY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1919 W 12TH ST, LITTLE ROCK, AR 72202-4551
(501) 364-7510
(501) 364-5194
Mailing address
1919 W 12TH ST, LITTLE ROCK, AR 72202-4551
(501) 364-7510
(501) 364-5194
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#1925
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146442721
—
AR
Enumeration date
09/13/2006
Last updated
06/30/2008
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