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General NPI Number Information
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NPI Number | 1861193484
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Entity Type | Organization
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Legal Business Name | JANNA L HINES THERAPY SERVICES LLC
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Dates
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Enumeration Date | 03/10/2023
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 201 SW 14TH ST STE 205
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City | BENTONVILLE
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State | AR
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Zip | 72712-7771
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Country | US
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Telephone | 479-544-2734
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Fax | 855-975-2995
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Provider Business Mailing Address
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Address Line | 3104 NE 12TH ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-3717
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Country | US
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Telephone | 479-544-2734
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Fax | 855-975-2995
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANNA L HINES
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Credential | MS, CCC-SLP
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Telephone | 479-544-2734
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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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