Provider Demographics
NPI:1710184486
Name:HENTON, ALICE M (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:M
Last Name:HENTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 E MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4751
Mailing Address - Country:US
Mailing Address - Phone:662-801-9595
Mailing Address - Fax:501-268-5443
Practice Address - Street 1:2501 E MOORE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4751
Practice Address - Country:US
Practice Address - Phone:662-801-9595
Practice Address - Fax:501-268-5443
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3094235Z00000X
MSS2858235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist