Provider Demographics
NPI:1144427212
Name:WENDY CASSADY SPEECH PATHOLOGY, INC
Entity Type:Organization
Organization Name:WENDY CASSADY SPEECH PATHOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PRIVETTE-CASSADY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:479-530-6025
Mailing Address - Street 1:191 IRELAND
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-4163
Mailing Address - Country:US
Mailing Address - Phone:479-530-6025
Mailing Address - Fax:479-419-5595
Practice Address - Street 1:986 ELMWOOD ST
Practice Address - Street 2:SUITE C
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-2720
Practice Address - Country:US
Practice Address - Phone:479-419-9911
Practice Address - Fax:479-419-5595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-01
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1659235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty