Individual
MISS TAYLOR RAE EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CF-SLP
Contact information
Practice address
610 N MISSOURI ST, WEST MEMPHIS, AR 72301-3148
(870) 400-0179
Mailing address
610 N MISSOURI ST, WEST MEMPHIS, AR 72301-3148
(870) 400-0179
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
200946
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200946
ABESPA
AR
Enumeration date
08/14/2017
Last updated
02/07/2020
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