Provider Demographics
NPI:1740043033
Name:SOTO, SUELI (SLPA)
Entity type:Individual
Prefix:MS
First Name:SUELI
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:MS
Other - First Name:SUELI
Other - Middle Name:ALVES
Other - Last Name:MALHEIROS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLPA
Mailing Address - Street 1:4733 KIBLER RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-8406
Mailing Address - Country:US
Mailing Address - Phone:479-268-2949
Mailing Address - Fax:
Practice Address - Street 1:4733 KIBLER RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956
Practice Address - Country:US
Practice Address - Phone:479-268-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202559235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist