Provider Demographics
NPI:1639723265
Name:DAGHER, HENRIETTA VERNELL (MSE, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HENRIETTA
Middle Name:VERNELL
Last Name:DAGHER
Suffix:
Gender:F
Credentials:MSE, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 EPERNAY CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5527
Mailing Address - Country:US
Mailing Address - Phone:601-415-7725
Mailing Address - Fax:
Practice Address - Street 1:54 EPERNAY CIR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5527
Practice Address - Country:US
Practice Address - Phone:601-415-7725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP413235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist