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Organization

SPA, INC.

Active
Other names
Sensational Kids
Organization subpart
No

Provider details

NPI number
Authorized official
LORI R MALONE MCDCCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(870) 336-0021
Entity
Organization

Contact information

Practice address
3423 E HIGHLAND DR STE A, JONESBORO, AR 72401-6404
(870) 336-0021
(870) 336-0022
Mailing address
3423 E HIGHLAND DR STE A, JONESBORO, AR 72401-6404
(870) 336-0021
(870) 336-0022

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1842
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142244721
AR
05
145524721
AR
05
145699721
AR
05
145811721
AR
05
148112721
AR
05
152429721
AR
05
157521742
AR
05
157682721
AR
05
161331721
AR
Enumeration date
04/04/2007
Last updated
06/20/2008
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