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General NPI Number Information
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NPI Number | 1306054622
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Entity Type | Organization
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Legal Business Name | BLESSED CHANGES
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6520 BASELINE RD
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City | LITTLE ROCK
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State | AR
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Zip | 72209-4732
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Country | US
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Telephone | 501-744-1645
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 190022
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City | LITTLE ROCK
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State | AR
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Zip | 72219-0022
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Country | US
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Telephone | 501-744-1645
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MELODY MILLER
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Credential |
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Telephone | 501-744-1645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | AR
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