Healthcare Provider Details

I. General information

NPI: 1932321502
Provider Name (Legal Business Name): STEPHENS SPEECH CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HIGHWAY 43 E SUITE 7
HARRISON AR
72601-2116
US

IV. Provider business mailing address

200 HIGHWAY 43 E SUITE 7
HARRISON AR
72601-2116
US

V. Phone/Fax

Practice location:
  • Phone: 870-741-0500
  • Fax: 870-741-6196
Mailing address:
  • Phone: 870-741-0500
  • Fax: 870-741-6196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name: KRISTAH REECE
Title or Position: MANAGER
Credential:
Phone: 870-741-0500