Provider Demographics
NPI:1689839433
Name:BROWNLEE, GLENDA POWELL (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:GLENDA
Middle Name:POWELL
Last Name:BROWNLEE
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-8811
Mailing Address - Country:US
Mailing Address - Phone:501-327-7060
Mailing Address - Fax:
Practice Address - Street 1:15 EAGLE ST
Practice Address - Street 2:VILONIA PUBLIC SCHOOLS
Practice Address - City:VILONIA
Practice Address - State:AR
Practice Address - Zip Code:72173
Practice Address - Country:US
Practice Address - Phone:501-796-2112
Practice Address - Fax:501-796-2445
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR372235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist