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Organization

KIDSPOT WALNUT RIDGE2

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GINA DEUTER (OWNER)
(870) 974-9114
Entity
Organization

Contact information

Practice address
KIDSPOT, 700 WEST MAIN, WALNUT RIDGE, AR 72476
(870) 637-5903
(870) 637-5908
Mailing address
KIDSPOT, 1801 GRANT AVE, JONESBORO, AR 72401-6155
(870) 974-9114
(870) 974-9184

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
224Z00000X
Occupational Therapy Assistant
225100000X
Physical Therapist
225200000X
Physical Therapy Assistant
225X00000X
Occupational Therapist
2355S0801X
Speech-Language Assistant
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
03/18/2022
Last updated
03/18/2022
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