# PEDIATRIC THERAPY WORKS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891562914
- **Authorized official:** MS. JAMIE FREDERICK MCD, CCC-SLP (CO-OWNER)
- **Authorized official phone:** (870) 270-7963

## Contact information

- **Practice address:** 111 MERRIMAN AVE E, WYNNE, AR 72396-2941
- **Practice address phone:** (870) 270-7963
- **Practice address fax:** (870) 374-6061
- **Mailing address:** 5 COUNTY ROAD 7290, WYNNE, AR 72396-8121
- **Mailing address phone:** (870) 270-7963
- **Mailing address fax:** (870) 374-6061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2023
- **Last updated:** 12/08/2023