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General NPI Number Information
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NPI Number | 1770619645
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Entity Type | Organization
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Legal Business Name | BALD KNOB SPECIAL SCHOOL DISTRICT
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 103 W PARK AVE
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City | BALD KNOB
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State | AR
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Zip | 72010-3162
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Country | US
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Telephone | 501-724-5015
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Fax | 501-724-6253
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Provider Business Mailing Address
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Address Line | 103 W PARK AVE
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City | BALD KNOB
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State | AR
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Zip | 72010-3162
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Country | US
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Telephone | 501-724-5015
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Fax | 501-724-6253
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. STACY SANDERS
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Credential | SLP
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Telephone | 501-724-3714
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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 | AR
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