Individual
TRENTCY PEAKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
135 APPLEGATE DR, CONWAY, AR 72034-5553
(501) 472-1024
(501) 329-8843
Mailing address
135 APPLEGATE DR, CONWAY, AR 72034-5553
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1680
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5-U589
BCBS
AR
Enumeration date
03/05/2007
Last updated
07/08/2007
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