| NPI | 1265658215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE POTTS President 870-930-6372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 104100000X Social Worker | |
| 222Q00000X Developmental Therapist | |
| 224Z00000X Occupational Therapy Assistant | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2024-05-15 |