Organization
KIDS FOR THE FUTURE OF MARIANNA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R HEISLER PHD (CEO)
(870) 295-5280
Entity
Organization
Contact information
Practice address
401 W MAIN ST, MARIANNA, AR 72360-2102
(870) 295-5280
(870) 295-5390
Mailing address
401 W MAIN ST, PO BOX 1102, MARIANNA, AR 72360-2102
(870) 295-5280
(870) 295-5390
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
14012
AR
235Z00000X
Speech-Language Pathologist
14012
AR
252Y00000X
Early Intervention Provider Agency
Primary
14012
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181131724
—
AR
Enumeration date
06/10/2010
Last updated
06/10/2010
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