Provider Demographics
NPI:1447304696
Name:STRICKLIN, AMY DENISE (SLP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:DENISE
Last Name:STRICKLIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCD, CCC-SLP
Mailing Address - Street 1:2309 CHARLESTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7025
Mailing Address - Country:US
Mailing Address - Phone:870-208-3450
Mailing Address - Fax:
Practice Address - Street 1:707 ELDRIDGE AVE E
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-4032
Practice Address - Country:US
Practice Address - Phone:870-208-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP 2407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR12091072OtherASHA ACCOUNT NUMBER
AR161714721Medicaid
AR5A099OtherBLUE CROSS & BLUE SHIELD