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General NPI Number Information
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NPI Number | 1912347378
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Entity Type | Organization
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Legal Business Name | GRETA HALE, SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 07/01/2013
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Provider Practice Location Address
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Address Line | 60 WOODRIDGE DR
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City | LITTLE ROCK
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State | AR
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Zip | 72204-7122
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Country | US
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Telephone | 501-749-1134
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Fax | 501-588-8861
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Provider Business Mailing Address
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Address Line | PO BOX 45371
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City | LITTLE ROCK
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State | AR
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Zip | 72214-5371
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Country | US
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Telephone | 501-749-1134
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Fax | 501-588-8861
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | MS. GRETA A. HALE
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Credential | SLP
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Telephone | 501-749-1134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | SP#2491
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License Number State | AR
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