Provider Demographics
NPI:1306614409
Name:TRIPLETT, BO (MCD, CF-SLP)
Entity type:Individual
Prefix:
First Name:BO
Middle Name:
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:MCD, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 FALLS BLVD N
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-4027
Mailing Address - Country:US
Mailing Address - Phone:870-588-5190
Mailing Address - Fax:870-621-2283
Practice Address - Street 1:1940 FALLS BLVD N
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-4027
Practice Address - Country:US
Practice Address - Phone:870-588-5190
Practice Address - Fax:870-621-2283
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist