Provider Demographics
NPI:1922337781
Name:MCCLELLAND, APRIL M
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:M
Last Name:MCCLELLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N NANCE ST
Mailing Address - Street 2:
Mailing Address - City:MONETTE
Mailing Address - State:AR
Mailing Address - Zip Code:72447-9795
Mailing Address - Country:US
Mailing Address - Phone:870-838-3582
Mailing Address - Fax:870-236-6389
Practice Address - Street 1:1005 BALCOM LN
Practice Address - Street 2:
Practice Address - City:TRUMANN
Practice Address - State:AR
Practice Address - Zip Code:72472-9502
Practice Address - Country:US
Practice Address - Phone:870-483-1461
Practice Address - Fax:870-483-6520
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
373H00000X
09-0106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR09-0106Medicaid