Provider Demographics
NPI:1033519681
Name:BULLARD, ERICA ELIZABETH (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:ELIZABETH
Last Name:BULLARD
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:ELIZABETH
Other - Last Name:CASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:2421 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-4150
Mailing Address - Country:US
Mailing Address - Phone:501-339-5128
Mailing Address - Fax:
Practice Address - Street 1:1609 WALDEN DR
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949
Practice Address - Country:US
Practice Address - Phone:479-667-4118
Practice Address - Fax:479-667-4092
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3792235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist