Provider Demographics
NPI:1518125145
Name:VINSON, AMY KATHRYN (MCD,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHRYN
Last Name:VINSON
Suffix:
Gender:F
Credentials:MCD,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 WATER ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-3455
Mailing Address - Country:US
Mailing Address - Phone:870-612-1716
Mailing Address - Fax:870-612-1718
Practice Address - Street 1:955 WATER ST STE 3
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-3455
Practice Address - Country:US
Practice Address - Phone:870-612-1716
Practice Address - Fax:870-612-1718
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8095235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist