Provider Demographics
NPI:1942475082
Name:STEWART, PAMULA FAYE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAMULA
Middle Name:FAYE
Last Name:STEWART
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LIGHTLE DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-9486
Mailing Address - Country:US
Mailing Address - Phone:501-268-6929
Mailing Address - Fax:501-278-2232
Practice Address - Street 1:801 N ELM ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-3640
Practice Address - Country:US
Practice Address - Phone:501-268-3517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR555235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist