Provider Demographics
NPI:1023296001
Name:NOWLIN, DAISEY L (MSE)
Entity type:Individual
Prefix:MR
First Name:DAISEY
Middle Name:L
Last Name:NOWLIN
Suffix:
Gender:F
Credentials:MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:FORREST CITY
Mailing Address - State:AR
Mailing Address - Zip Code:72335-2708
Mailing Address - Country:US
Mailing Address - Phone:870-633-1796
Mailing Address - Fax:870-261-1818
Practice Address - Street 1:836 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-2708
Practice Address - Country:US
Practice Address - Phone:870-633-1796
Practice Address - Fax:870-261-1818
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist