Individual
MRS. GINA RENEA DEUTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD CCC-SLP
Contact information
Practice address
2917 KING ST, SUITE A, JONESBORO, AR 72401-5322
(870) 974-9114
(870) 974-9184
Mailing address
1801 GRANT AVE, JONESBORO, AR 72401-6155
(870) 974-9114
(870) 974-9184
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#1713
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139117721
—
AR
01
—
5U700
BLUE CROSS BLUE SHIELD #
AR
Enumeration date
05/10/2006
Last updated
11/19/2018
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