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General NPI Number Information
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NPI Number | 1699692657
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Entity Type | Organization
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Legal Business Name | TIA TEAGUE THERAPY SERVICES LLC
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 102 N OAK ST
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City | HACKETT
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State | AR
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Zip | 72937-4756
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Country | US
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Telephone | 479-638-8606
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Fax |
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Provider Business Mailing Address
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Address Line | 3710 OLD OAKS LN
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City | FORT SMITH
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State | AR
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Zip | 72903-3336
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Country | US
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Telephone | 479-208-2288
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | TIA TEAGUE
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Credential | MS CCC-SLP
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Telephone | 479-208-2288
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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 |
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