Provider Demographics
NPI:1245456292
Name:FARLEY, KAREN WILSON
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:WILSON
Last Name:FARLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 COUNTY ROAD 418
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-7592
Mailing Address - Country:US
Mailing Address - Phone:870-930-6358
Mailing Address - Fax:870-930-9336
Practice Address - Street 1:1416 REDBUD CIR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5735
Practice Address - Country:US
Practice Address - Phone:870-206-3561
Practice Address - Fax:870-930-9336
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR142779721Medicaid