Organization
KIDS UNLIMITED LEARNING ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY DECKER MCD, CCC-SLP (CEO)
(870) 761-6680
Entity
Organization
Contact information
Practice address
2792 S 2ND ST, SUITES B & C, CABOT, AR 72023-7020
(870) 761-6680
Mailing address
1901 PINE VALLEY LN, JONESBORO, AR 72404-8435
(870) 761-6680
(501) 246-7919
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199934742
—
AR
Enumeration date
07/01/2013
Last updated
08/14/2014
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