Provider Demographics
NPI:1669630976
Name:THOMPSON, LADONNA SUE (MSE, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:LADONNA
Middle Name:SUE
Last Name:THOMPSON
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 1:191 PUMPING STATION RD
Mailing Address - Street 2:
Mailing Address - City:BALD KNOB
Mailing Address - State:AR
Mailing Address - Zip Code:72010-9405
Mailing Address - Country:US
Mailing Address - Phone:501-724-3714
Mailing Address - Fax:
Practice Address - Street 1:103 W PARK AVE
Practice Address - Street 2:
Practice Address - City:BALD KNOB
Practice Address - State:AR
Practice Address - Zip Code:72010-3162
Practice Address - Country:US
Practice Address - Phone:501-724-3714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist