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Individual

MRS. LEZLE CHURCH RUPERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
2 BLOWING SPRINGS RD, BELLA VISTA, AR 72714-3552
(479) 696-3700
Mailing address
500 TIGER BLVD, BENTONVILLE, AR 72712-4208
(479) 254-5065

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#1069
AR

Other

Enumeration date
08/13/2009
Last updated
08/13/2009
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