Provider Demographics
NPI:1043466972
Name:DROHO, MARY
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:DROHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12158 CLYDE EDWARDS RD
Mailing Address - Street 2:
Mailing Address - City:GENTRY
Mailing Address - State:AR
Mailing Address - Zip Code:72734-9138
Mailing Address - Country:US
Mailing Address - Phone:479-524-0358
Mailing Address - Fax:479-524-0385
Practice Address - Street 1:1900 N MOUNT OLIVE ST
Practice Address - Street 2:ALLEN ELEMENTARY
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-8953
Practice Address - Country:US
Practice Address - Phone:479-524-0358
Practice Address - Fax:479-524-0385
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist