Healthcare Provider Details

I. General information

NPI: 1295550499
Provider Name (Legal Business Name): WILLOWS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 W SCHOOL ST STE 6
BROOKLAND AR
72417-9171
US

IV. Provider business mailing address

6538 HIGHWAY 141 N
JONESBORO AR
72401-0321
US

V. Phone/Fax

Practice location:
  • Phone: 870-200-9299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BELINDA BAXLEY
Title or Position: OWNER/ADMINISTRATIVE DIRECTOR
Credential:
Phone: 870-200-9299