Individual
MRS. TARA MARIE DENNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.CCC-SLP
Contact information
Practice address
1600 RIVERFRONT DRIVE, LITTLE ROCK, AR 72202
(501) 663-6965
Mailing address
1619 GAMBLE RD, LITTLE ROCK, AR 72211-4193
(501) 312-0234
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2001
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X334
BLUE CROSS BLUE SHIELD
AR
Enumeration date
11/15/2006
Last updated
07/08/2007
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