Individual
RETA LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
161 MILDRED SIMPSON DR, NORFORK, AR 72658-8415
(870) 499-7192
(870) 499-7196
Mailing address
161 MILDRED SIMPSON DR, NORFORK, AR 72658-8415
(870) 499-7192
(870) 499-7196
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
235Z00000X TAXONOMY
AR
Other
Enumeration date
06/03/2009
Last updated
11/26/2012
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