Healthcare Provider Details

I. General information

NPI: 1912696402
Provider Name (Legal Business Name): KIDSPIRATION TOO MOUNTAIN VIEW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 03/29/2024
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 WEST STREET
MOUNTAIN VIEW AR
72560
US

IV. Provider business mailing address

103 ALLEN RD
MOUNTAIN VIEW AR
72560-9102
US

V. Phone/Fax

Practice location:
  • Phone: 870-269-8090
  • Fax: 870-368-4587
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. REGAN COTTER
Title or Position: OWNER
Credential:
Phone: 870-368-4586