Individual
MIRIAM STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2474 E JOYCE BLVD STE 2, FAYETTEVILLE, AR 72703-4932
(479) 521-8326
(479) 521-5439
Mailing address
3636 W DALLAS ST, HOUSTON, TX 77019-1704
(713) 523-4722
(713) 523-8399
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
109054
TX
235Z00000X
Speech-Language Pathologist
Primary
200076
AR
Other
Enumeration date
07/17/2013
Last updated
02/03/2022
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