Individual
BONNY BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2915 S HAZEL ST, PINE BLUFF, AR 71603-5008
(870) 535-0010
Mailing address
707 ELDRIDGE AVE E, WYNNE, AR 72396-4032
(870) 208-8989
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1947
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X214
BLUE CROSS & BLUE SHIELD
AR
Enumeration date
01/24/2007
Last updated
07/09/2007
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