Provider Demographics
NPI:1508901117
Name:ASLIN, LARRY WYNARD (MA CCC SLP)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:WYNARD
Last Name:ASLIN
Suffix:
Gender:M
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:790 EAST ELM STREET
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703
Mailing Address - Country:US
Mailing Address - Phone:479-521-0485
Mailing Address - Fax:
Practice Address - Street 1:410 ARKANSAS AVENUE
Practice Address - Street 2:UNIVERSITY SPEECH & HEARING CLINIC
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-1201
Practice Address - Country:US
Practice Address - Phone:479-575-4918
Practice Address - Fax:479-575-4507
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARST204OtherBCBS