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NPI 1639860208

NPI 1639860208 : AMIGOS PEDIATRIC THERAPY SERVICES, INC : NORTH LITTLE ROCK, AR

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General NPI Number Information
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    NPI Number           |    1639860208
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    Entity Type          |    Organization 
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    Legal Business Name  |    AMIGOS PEDIATRIC THERAPY SERVICES, INC 
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Dates
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    Enumeration Date     |    05/16/2023
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    Last Update Date     |    10/15/2025
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Provider Practice Location Address
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    Address Line         |    4131 JFK BLVD STE C 
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    City                 |    NORTH LITTLE ROCK
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    State                |    AR
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    Zip                  |    72116-8264
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    Country              |    US
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    Telephone            |    501-502-5420
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    Fax                  |    501-557-3657
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Provider Business Mailing Address
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    Address Line         |    4131 JFK BLVD STE C 
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    City                 |    NORTH LITTLE ROCK
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    State                |    AR
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    Zip                  |    72116-8264
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    Country              |    US
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    Telephone            |    501-502-5420
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    Fax                  |    501-557-3657
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MRS. ASHLEY VILLARREAL FLEEMAN 
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    Credential           |    MS CCC-SLP
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    Telephone            |    501-502-5420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical 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        |    225X00000X
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    Taxonomy Name        |    Occupational 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        |    224Z00000X
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    Taxonomy Name        |    Occupational Therapy Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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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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