Organization
SQUARE ONE OT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATELYN ALLEN OTD (OWNER)
(573) 213-9467
Entity
Organization
Contact information
Practice address
1202 NE MCCLAIN RD BLDG 7, BENTONVILLE, AR 72712-3875
(573) 213-9467
Mailing address
21 CHELSEA LN, BELLA VISTA, AR 72715-6522
(573) 213-9467
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/05/2021
Last updated
11/05/2021
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