MEDICARE: MEETING MILESTONES PEDIATRIC THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1154276103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEETING MILESTONES PEDIATRIC THERAPY LLC

Provider Business Mailing Address
First Line	:	8619 W FOREST HILLS DR
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72704-7850
Country	:	US
Telephone Number	:	417-846-7685
Fax Number	:

Provider Business Practice Location Address
First Line	:	8619 W FOREST HILLS DR
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72704-7850
Country	:	US
Telephone Number	:	417-846-7685
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	JESSICA F YANG
Credential	:	MOT, OTR/L
Telephone Number	:	417-846-7685

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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