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General NPI Number Information
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NPI Number | 1740599935
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Entity Type | Organization
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Legal Business Name | ADVANCED SPEECH THERAPY LLC
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Dates
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Enumeration Date | 10/05/2010
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Last Update Date | 10/12/2010
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Provider Practice Location Address
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Address Line | 10014 N RODNEY PARHAM RD SUITE 101
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City | LITTLE ROCK
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State | AR
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Zip | 72227-5548
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Country | US
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Telephone | 501-960-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 10014 N RODNEY PARHAM RD SUITE 101
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City | LITTLE ROCK
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State | AR
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Zip | 72227-5548
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Country | US
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Telephone | 501-960-3400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMIE REBECCA TOWNLEY
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Credential | SLP, CCC
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Telephone | 501-960-3400
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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 | 2622
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License Number State | AR
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