Organization
MIRACLE KIDS SUCCESS ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY BARNT (BILLING COORDINATOR)
(870) 793-3200
Entity
Organization
Contact information
Practice address
200 GENERAL ST, BATESVILLE, AR 72501-9407
(870) 793-3200
Mailing address
200 GENERAL ST, BATESVILLE, AR 72501-9407
(870) 793-3200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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