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General NPI Number Information
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NPI Number | 1841389301
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Entity Type | Organization
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Legal Business Name | EAVES-TAYLOR THERAPY, INC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1389 LAFITE LN
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-9808
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Country | US
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Telephone | 501-351-2301
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Fax | 501-325-0678
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Provider Business Mailing Address
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Address Line | 1389 LAFITE LN
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-9808
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Country | US
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Telephone | 501-351-2301
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Fax | 501-325-0678
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Authorized Official
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Title or Position | OWNER
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Name | LAURA TAYLOR
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Credential | CCC
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Telephone | 501-351-2301
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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 | SP#1277
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License Number State | AR
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