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Individual

MISTY MICHELLE WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MCD, CCC-SLP

Contact information

Practice address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 933-9528
(870) 933-9778
Mailing address
1908 OAKWOOD CIR, JONESBORO, AR 72404-7755
(870) 972-6843

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#1660
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5U809
BLUE CROSS BLUE SHIELD
AR
Enumeration date
02/01/2007
Last updated
07/08/2007
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