Individual
MR. BRIAN WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, CCC-SLP
Contact information
Practice address
7201 BLACKJACK DR, FORT SMITH, AR 72916-8904
(479) 649-7044
Mailing address
7201 BLACKJACK DR, FORT SMITH, AR 72916-8904
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1783
AR
Other
Enumeration date
04/24/2007
Last updated
07/09/2007
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