MEDICARE: KIDS POINT THERAPY

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	252Y00000X	Early Intervention Provider Agency		AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992132955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDS POINT THERAPY

Provider Business Mailing Address
First Line	:	5704 WISTERIA CT
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72118-3556
Country	:	US
Telephone Number	:	501-412-5621
Fax Number	:	888-472-0526

Provider Business Practice Location Address
First Line	:	5704 WISTERIA CT
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72118-3556
Country	:	US
Telephone Number	:	501-412-5621
Fax Number	:	888-472-0526

Authorized Official
Title or Position	:	OWNER
Name	:	BONNIE KATHERINE REESE
Credential	:	M.S.'CCC-SLP
Telephone Number	:	501-412-5621

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	10/03/2013

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Directions to “KIDS POINT THERAPY ” Practice Location

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