Provider Demographics
NPI:1639200835
Name:BUTLER, REBECCA I (SLP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:I
Last Name:BUTLER
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 1:1303 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8617
Mailing Address - Country:US
Mailing Address - Phone:870-777-3807
Mailing Address - Fax:
Practice Address - Street 1:500 S SPRUCE ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-5423
Practice Address - Country:US
Practice Address - Phone:870-777-3076
Practice Address - Fax:870-777-5793
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#571235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist