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General NPI Number Information
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NPI Number | 1922887223
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Entity Type | Organization
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Legal Business Name | LATADA ENRICHMENT THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 09/26/2023
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 3411 MAIN ST STE 5
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City | BRYANT
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State | AR
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Zip | 72022-8032
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Country | US
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Telephone | 501-240-8098
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Fax |
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Provider Business Mailing Address
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Address Line | 2296 PLEASANT FOREST DR
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City | BENTON
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State | AR
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Zip | 72015-4992
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Country | US
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Telephone | 501-240-8098
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELNIKA J HALE
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Credential |
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Telephone | 501-240-8098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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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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