Individual
AMY LICKENBROCK WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS, CCC-SLP
Contact information
Practice address
1412 PARK ST, LOWELL, AR 72745-6028
(479) 379-2827
Mailing address
1412 PARK ST, LOWELL, AR 72745-6028
(479) 379-2827
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2017026191
AR
235Z00000X
Speech-Language Pathologist
Primary
2017026191
MO
Other
Enumeration date
08/07/2017
Last updated
01/16/2026
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