Organization
ARKANSAS THERAPY SOURCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER CHRISTY ROGERS M.S.,CCC-SLP (OWENER)
(501) 249-8649
Entity
Organization
Contact information
Practice address
116 VALDERRAMA DR, BENTON, AR 72015-8971
(501) 249-8649
(501) 315-0847
Mailing address
116 VALDERRAMA DR, BENTON, AR 72015-8971
(501) 249-8649
(501) 315-0847
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2309
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165756742
—
AR
Enumeration date
06/26/2008
Last updated
06/26/2008
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