Provider Demographics
NPI:1881030732
Name:RICHARDS, DUSTIN MATTHEW (AUD)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:MATTHEW
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 E CITIZENS DR STE 7
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4797
Mailing Address - Country:US
Mailing Address - Phone:501-551-6058
Mailing Address - Fax:
Practice Address - Street 1:2630 E CITIZENS DR STE 7
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4797
Practice Address - Country:US
Practice Address - Phone:479-957-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist