Provider Demographics
NPI:1346599107
Name:EDDINGTON, JUDITH ANNE (SLP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANNE
Last Name:EDDINGTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 MARYLANE DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-6702
Mailing Address - Country:US
Mailing Address - Phone:479-936-1381
Mailing Address - Fax:479-631-8993
Practice Address - Street 1:2403 MARYLANE DR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-6702
Practice Address - Country:US
Practice Address - Phone:479-936-1381
Practice Address - Fax:479-631-8993
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#242235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist