Provider Demographics
NPI:1679696918
Name:MCNEELY, DARLA L (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:L
Last Name:MCNEELY
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:PO DRAWER 2109
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811
Mailing Address - Country:US
Mailing Address - Phone:479-967-2322
Mailing Address - Fax:
Practice Address - Street 1:6924 SR 247
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72858-8948
Practice Address - Country:US
Practice Address - Phone:479-890-6858
Practice Address - Fax:479-890-6866
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP1950235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145453721Medicaid
ARSP1950OtherLICENSE NUMBER
AR5Y578OtherBLUE CROSS ID NUMBER
AR12028545OtherAMERICAN ST, LANG, ASSOC