Provider Demographics
NPI:1194074203
Name:BATTENFIELD, KASEY MICHELLE (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:MICHELLE
Last Name:BATTENFIELD
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2662 E JOYCE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4434
Mailing Address - Country:US
Mailing Address - Phone:479-521-7337
Mailing Address - Fax:479-521-7338
Practice Address - Street 1:2662 E JOYCE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4434
Practice Address - Country:US
Practice Address - Phone:479-521-7337
Practice Address - Fax:479-521-7338
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8554235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist