Individual
MICHELLE A REAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
1214 OPAL CIR, VAN BUREN, AR 72956-6486
(479) 806-3131
Mailing address
1214 OPAL CIR, VAN BUREN, AR 72956-6486
(479) 806-3131
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12059384
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150236721
—
AR
Enumeration date
03/14/2007
Last updated
07/09/2007
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