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General NPI Number Information
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NPI Number | 1215816715
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Entity Type | Organization
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Legal Business Name | GUIDED GROWTH THERAPY PLLC
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 209 N COLLEGE ST STE A
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3653
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Country | US
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Telephone | 870-888-1061
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Fax |
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Provider Business Mailing Address
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Address Line | 209 N COLLEGE ST STE A
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3653
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Country | US
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Telephone | 870-421-4816
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Fax | 870-263-3044
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Authorized Official
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Title or Position | OWNER
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Name | KELSEY BOWERS
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Credential | BCBA
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Telephone | 870-421-4816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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