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General NPI Number Information
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NPI Number | 1215420732
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Entity Type | Organization
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Legal Business Name | KAYLEE LUTTRELL SPEECH PATHOLOGY PLLC
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Dates
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Enumeration Date | 06/09/2018
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 5302 W VILLAGE PKWY STE 1
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City | ROGERS
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State | AR
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Zip | 72758-8139
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Country | US
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Telephone | 479-659-1899
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 SW RADIANCE AVE
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City | BENTONVILLE
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State | AR
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Zip | 72713-2135
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Country | US
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Telephone | 479-659-1899
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | KAYLEE ALDER
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Credential |
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Telephone | 479-401-2077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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