Individual
JENNIFER DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
116 COUNTY ROAD 457, JONESBORO, AR 72404-8225
(870) 219-3867
Mailing address
116 COUNTY ROAD 457, JONESBORO, AR 72404-8225
(870) 219-3867
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP#2054
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149650721
—
AR
Enumeration date
09/21/2007
Last updated
09/09/2014
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