Healthcare Provider Details

I. General information

NPI: 1356313340
Provider Name (Legal Business Name): REGIONAL THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 09/18/2021
Certification Date: 09/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 W HUDSON RD
ROGERS AR
72756
US

IV. Provider business mailing address

2510 W HUDSON RD
ROGERS AR
72756
US

V. Phone/Fax

Practice location:
  • Phone: 479-936-1061
  • Fax: 855-812-1132
Mailing address:
  • Phone: 479-936-1061
  • Fax: 855-812-1132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1654
License Number StateAR

VIII. Authorized Official

Name: MRS. DEEDRA ANN BRANSCUM
Title or Position: PRESIDENT
Credential: CCC-SLP
Phone: 479-790-7979