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Individual

MRS. MIRANDA IRENE SANDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
1501 S DETROIT AVE, RUSSELLVILLE, AR 72801-7247
(479) 968-2084
Mailing address
15 ROSEMARY LN, CLARKSVILLE, AR 72830-9186
(479) 567-0133

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1607
NH
235Z00000X
Speech-Language Pathologist
Primary
SP#2677
AR
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
09/19/2008
Last updated
09/09/2022
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