Healthcare Provider Details

I. General information

NPI: 1114833076
Provider Name (Legal Business Name): KIDS UNLIMITED LEARNING ACADEMY OF CABOT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3148 HIGHWAY 367 S
CABOT AR
72023-7473
US

IV. Provider business mailing address

3148 HIGHWAY 367 S
CABOT AR
72023-7473
US

V. Phone/Fax

Practice location:
  • Phone: 501-941-3500
  • Fax: 501-246-7919
Mailing address:
  • Phone: 501-941-3500
  • Fax: 877-769-1668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SHELLY A. KELLER
Title or Position: CEO
Credential:
Phone: 870-932-3600