Basic Information
| Provider Information | |||||||||
| NPI: | 1891430344 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDDLEMAN | ||||||||
| FirstName: | SYDNEY | ||||||||
| MiddleName: | ERIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 151 SOUTHWEST DR | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724015828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709320090 | ||||||||
| FaxNumber: | 8709309336 | ||||||||
| Practice Location | |||||||||
| Address1: | 517 N 14TH ST STE 7 | ||||||||
| Address2: | |||||||||
| City: | PARAGOULD | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724503550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709320090 | ||||||||
| FaxNumber: | 8709309336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2022 | ||||||||
| LastUpdateDate: | 04/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.