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General NPI Number Information
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NPI Number | 1801480652
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Entity Type | Organization
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Legal Business Name | SPEECHWORKS THERAPY SERVICES LLC
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 1407 MARKETPLACE DR STE 1
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City | JONESBORO
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State | AR
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Zip | 72401-5227
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Country | US
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Telephone | 870-761-1417
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 83
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City | HARRISBURG
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State | AR
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Zip | 72432-0083
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Country | US
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Telephone | 870-761-1417
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Fax |
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Authorized Official
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Title or Position | OWNER / SPEECH PATHOLOGIST
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Name | GWENDDLYN GRAY
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Credential | SLP
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Telephone | 870-761-1417
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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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