Individual
MRS. LAURA BETH BASSHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.C.D.
Contact information
Practice address
1300 FALLS BLVD N, WYNNE, AR 72396-1622
(870) 238-5032
Mailing address
3419 HIGHWAY 284, WYNNE, AR 72396-8116
(870) 588-1239
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1024
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173592795
—
AR
Enumeration date
08/21/2008
Last updated
01/06/2009
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