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Organization

LOOBYLOO THERAPY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CANDICE DIANE REED M.S., CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(870) 224-3585
Entity
Organization

Contact information

Practice address
113 WOODBERRY, CROSSETT, AR 71635-3926
(870) 224-3585
(870) 304-2595
Mailing address
113 WOODBERRY, CROSSETT, AR 71635-3926
(870) 224-3585
(870) 304-2595

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SP#2375
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1104033059
PERSONAL NPI NUMBER
AR
05
162452721
AR
Enumeration date
10/25/2012
Last updated
10/25/2012
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