Individual
MRS. PAMELA K PETRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCSLP
Contact information
Practice address
91 NEAL ST, HOPE FOR TOMORROW, FARMINGTON, AR 72730
(479) 267-4673
Mailing address
18036 SUNSET RD, WINSLOW, AR 72959
(479) 267-4673
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1442
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X943
BCBS
AR
Enumeration date
08/14/2006
Last updated
07/08/2007
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