Provider Demographics
NPI:1285710210
Name:RHOADS, JAMI LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JAMI
Middle Name:LYNN
Last Name:RHOADS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 JACKSONVILLE-CONWAY ROAD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076
Mailing Address - Country:US
Mailing Address - Phone:501-350-8441
Mailing Address - Fax:
Practice Address - Street 1:2200 THORNHILL DR
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-3161
Practice Address - Country:US
Practice Address - Phone:501-833-1190
Practice Address - Fax:501-982-1253
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2253235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARSP#2253OtherLICENSE NUMBER
AR156609721Medicaid