Organization
MIRACLE KIDS SUCCESS ACADEMY OF PARAGOULD
Active
Organization
MIRACLE KIDS SUCCESS ACADEMY OF PARAGOULD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLY KELLER (CEO)
(870) 761-6680
Entity
Organization
Contact information
Practice address
1910 RECTOR RD, PARAGOULD, AR 72450-2004
(870) 932-3600
Mailing address
1900 STILLWATER DR, JONESBORO, AR 72404-9119
(870) 932-3600
(870) 932-3611
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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