Healthcare Provider Details

I. General information

NPI: 1215420732
Provider Name (Legal Business Name): KAYLEE LUTTRELL SPEECH PATHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2018
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5302 W VILLAGE PKWY STE 1
ROGERS AR
72758-8139
US

IV. Provider business mailing address

3700 SW RADIANCE AVE
BENTONVILLE AR
72713-2135
US

V. Phone/Fax

Practice location:
  • Phone: 479-659-1899
  • Fax:
Mailing address:
  • Phone: 479-659-1899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: KAYLEE ALDER
Title or Position: SPEECH-LANGUAGE PATHOLOGIST/OWNER
Credential:
Phone: 479-401-2077