Individual
MRS. MYRANDA NOELLE VICTORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, CCC-SLP
Contact information
Practice address
3511 N. SILENT GROVE RD., SPRINGDALE, AR 72762-7913
(479) 750-8775
(855) 222-5520
Mailing address
3511 N. SILENT GROVE RD., SPRINGDALE, AR 72762-7913
(479) 750-8775
(855) 222-5520
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3048
AR
235Z00000X
Speech-Language Pathologist
P8401
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186790721
—
AR
Enumeration date
06/16/2011
Last updated
10/23/2024
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