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Contact Information

CASEY R TISDALE
1616 S. SPRING ST.
LITTLE ROCK, AR72206
 Phone: 205-942-6820
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for CASEY R TISDALE · (Female)

NPI # 1518289198
Status Active
Credentials
Entity Individual
Enumeration date 02/23/2010
Last updated 10/10/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • License # 12083868ASHA
  • AL License # 2753
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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