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General NPI Number Information
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NPI Number | 1558758805
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Entity Type | Organization
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Legal Business Name | PIERONI SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 04/23/2015
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Provider Practice Location Address
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Address Line | 1806 LAKEHALL RD
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-6105
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Country | US
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Telephone | 501-454-1917
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 LAKEHALL RD P.O. BOX 563
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-6105
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Country | US
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Telephone | 501-454-1917
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. REBECCA PIERONI
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Credential | M.S. CCC-SLP
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Telephone | 501-454-1917
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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 | SP#2687
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License Number State | AR
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