Individual
MRS. MARILYN PHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC A
Contact information
Practice address
999 SCHNEIDER DRIVE, MALVERN, AR 72104
(501) 337-9500
(501) 337-1944
Mailing address
999 SCHNEIDER DRIVE, MALVERN, AR 72104
(501) 337-9500
(501) 337-1944
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
A95
AR
235Z00000X
Speech-Language Pathologist
Primary
SP#P7954
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56468
MEDIPAK ARK BCBS
AR
Enumeration date
04/22/2006
Last updated
08/24/2007
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