Provider Demographics
NPI:1013288059
Name:PATRICK, NITA CHRISTINE (SLP-A)
Entity type:Individual
Prefix:
First Name:NITA
Middle Name:CHRISTINE
Last Name:PATRICK
Suffix:
Gender:
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3525
Mailing Address - Country:US
Mailing Address - Phone:479-899-8927
Mailing Address - Fax:
Practice Address - Street 1:570 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740-9244
Practice Address - Country:US
Practice Address - Phone:479-899-8927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant