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General NPI Number Information
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NPI Number | 1932685203
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Entity Type | Organization
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Legal Business Name | CHILDREN'S THERAPY SERVICES, INC
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 2418 E JOYCE BLVD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4519
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Country | US
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Telephone | 479-935-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 2474 E JOYCE BLVD STE 2
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4932
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Country | US
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Telephone | 479-521-8326
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KYMBRLY HANNAH
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Credential |
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Telephone | 479-521-8326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-1728399
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License Number State | AR
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