Healthcare Provider Details

I. General information

NPI: 1982160834
Provider Name (Legal Business Name): SPEECH THERAPY SOLUTIONS OF CENTRAL ARKANSAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 ERNIE DAVIS RD
AUSTIN AR
72007-9381
US

IV. Provider business mailing address

PO BOX 95282
NORTH LITTLE ROCK AR
72190-5282
US

V. Phone/Fax

Practice location:
  • Phone: 501-732-0321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CASEY KEENEY
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential:
Phone: 501-773-5645