Provider Demographics
NPI:1245345529
Name:SOWELL, THOMAS W (MS,CCC/SLP)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:W
Last Name:SOWELL
Suffix:
Gender:M
Credentials:MS,CCC/SLP
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:SOWELL
Other - Suffix:I
Other - Last Name Type:Other Name
Other - Credentials:MS,CCC/SLP
Mailing Address - Street 1:6012 EAGLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-5778
Mailing Address - Country:US
Mailing Address - Phone:501-257-5344
Mailing Address - Fax:
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:SPEECH PATHOLOGY AND AUDIOLOGY
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5446
Practice Address - Country:US
Practice Address - Phone:501-257-5344
Practice Address - Fax:501-257-5251
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#581235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist