Healthcare Provider Details

I. General information

NPI: 1154276103
Provider Name (Legal Business Name): MEETING MILESTONES PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8619 W FOREST HILLS DR
FAYETTEVILLE AR
72704-7850
US

IV. Provider business mailing address

8619 W FOREST HILLS DR
FAYETTEVILLE AR
72704-7850
US

V. Phone/Fax

Practice location:
  • Phone: 417-846-7685
  • Fax:
Mailing address:
  • Phone: 417-846-7685
  • Fax: 479-351-7129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA F YANG
Title or Position: OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 417-846-7685