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General NPI Number Information
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NPI Number | 1407862253
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Entity Type | Organization
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Legal Business Name | CORNERSTONE KIDS THERAPY SERVICES, INC.
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1515 HARRISON ST STE B
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City | BATESVILLE
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State | AR
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Zip | 72501-7222
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Country | US
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Telephone | 870-793-1925
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 HARRISON ST STE B
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City | BATESVILLE
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State | AR
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Zip | 72501-7222
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Country | US
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Telephone | 870-793-1925
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MISS CASEY L CONNELL
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Credential | MS
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Telephone | 870-793-1925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR1758
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License Number State | AR
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