Healthcare Provider Details

I. General information

NPI: 1316592801
Provider Name (Legal Business Name): ABOVE AND BEYOND PEDIATRIC THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 08/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 AMERICAN ST. STE B
SPRINGDALE AR
72764
US

IV. Provider business mailing address

2700 AMERICAN ST. STE B
SPRINGDALE AR
72764
US

V. Phone/Fax

Practice location:
  • Phone: 870-588-5860
  • Fax:
Mailing address:
  • Phone: 870-588-5860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. ALLISON PRIBBLE DOAN
Title or Position: PRESIDENT-OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 870-588-5860