Provider Demographics
NPI:1063022986
Name:ADULT SPEECH AND VOICE CARE OF NORTHWEST ARKANSAS, LLC
Entity Type:Organization
Organization Name:ADULT SPEECH AND VOICE CARE OF NORTHWEST ARKANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TORRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:479-358-7819
Mailing Address - Street 1:1516 N CORSICA DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6168
Mailing Address - Country:US
Mailing Address - Phone:479-358-7819
Mailing Address - Fax:
Practice Address - Street 1:1516 N CORSICA DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-6168
Practice Address - Country:US
Practice Address - Phone:479-358-7819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty