Provider Demographics
NPI:1205094224
Name:STEWART, LINDA P (CCC/SLP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:P
Last Name:STEWART
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7558 CARRIE DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-1660
Mailing Address - Country:US
Mailing Address - Phone:501-316-1004
Mailing Address - Fax:
Practice Address - Street 1:2700 N POPLAR ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-2332
Practice Address - Country:US
Practice Address - Phone:501-771-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR359235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist