Provider Demographics
NPI:1578382644
Name:STEPHENSON, SOPHIE (SLPA)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:SOPHIE
Other - Middle Name:
Other - Last Name:QUICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2518
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72654-2518
Mailing Address - Country:US
Mailing Address - Phone:870-656-7440
Mailing Address - Fax:870-424-3208
Practice Address - Street 1:100 E 9TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-4704
Practice Address - Country:US
Practice Address - Phone:870-404-5870
Practice Address - Fax:870-424-3208
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2028762355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty