Organization
ARKANSAS THERAPY OUTREACH CONTRACTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLA MOORE (SPEECH LANGUAGE PATHOLOGIST)
(501) 358-9894
Entity
Organization
Contact information
Practice address
2615 N PRICKETT RD STE 3, BRYANT, AR 72022-7546
(501) 847-7337
Mailing address
2615 N PRICKETT RD STE 3, BRYANT, AR 72022-7546
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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