Individual
OLIVIA PEEK GOODON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2913 MIMOSA DR, NEWPORT, AR 72112-4728
(870) 718-3452
Mailing address
2913 MIMOSA DR, NEWPORT, AR 72112-4728
(870) 718-3452
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
200364
AR
Other
Enumeration date
12/06/2017
Last updated
08/11/2020
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