Healthcare Provider Details

I. General information

NPI: 1093956344
Provider Name (Legal Business Name): JULIE MATKINS LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 LITTLE FLOCK DR
ROGERS AR
72756-7042
US

IV. Provider business mailing address

2113 LITTLE FLOCK DR
ROGERS AR
72756-7042
US

V. Phone/Fax

Practice location:
  • Phone: 479-621-0385
  • Fax:
Mailing address:
  • Phone: 479-621-0385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA 1884
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA2301013
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: