Healthcare Provider Details

I. General information

NPI: 1194631051
Provider Name (Legal Business Name): KIDS UNLIMITED LEARNING ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E RACE AVE
SEARCY AR
72143-4417
US

IV. Provider business mailing address

502 E RACE AVE
SEARCY AR
72143-4417
US

V. Phone/Fax

Practice location:
  • Phone: 501-268-3400
  • Fax: 501-613-0855
Mailing address:
  • Phone: 501-268-3400
  • Fax: 501-613-0855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SHELLY A. KELLER
Title or Position: CEO
Credential:
Phone: 870-932-3600