Provider Demographics
NPI:1386775930
Name:BARRILLEAUX, DANA WILCOX (SLP)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:WILCOX
Last Name:BARRILLEAUX
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 HALEY LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3461
Mailing Address - Country:US
Mailing Address - Phone:501-329-6881
Mailing Address - Fax:
Practice Address - Street 1:1515 HALEY LN
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3461
Practice Address - Country:US
Practice Address - Phone:501-329-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist