Individual
STACEY SMITHERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 WILSON LOOP ROAD, WARD, AR 72176
(501) 941-5630
Mailing address
16 TOWNE PARK CT APT 1, LITTLE ROCK, AR 72227-6279
(501) 412-3863
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1926
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W577
BLUE CROSS BLUE SHEILD
AR
Enumeration date
02/26/2007
Last updated
03/17/2025
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