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Individual

DR. IDA LINDA TRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D

Contact information

Practice address
122 ROSE, BERRYVILLE, AR 72616
(870) 423-9133
Mailing address
P.O. BOX 771, BERRYVILLE, AR 72618
(870) 423-9133

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
#316
AR
171R00000X
Interpreter
#291,#292
AR
235Z00000X
Speech-Language Pathologist
#317
AR

Other

Enumeration date
04/13/2011
Last updated
04/13/2011
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