Provider Demographics
NPI:1578816690
Name:COTTRELL, SUNNI ELIZABETH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUNNI
Middle Name:ELIZABETH
Last Name:COTTRELL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 CHOATE ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-8592
Mailing Address - Country:US
Mailing Address - Phone:870-692-2300
Mailing Address - Fax:
Practice Address - Street 1:1415 CHOATE ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-8592
Practice Address - Country:US
Practice Address - Phone:870-692-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist