Organization
THERA-PLAY PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN B OLIVER M.C.D., CCC-SLP (CFO)
(479) 856-2626
Entity
Organization
Contact information
Practice address
1310 W ROBINSON AVE, SPRINGDALE, AR 72764-0940
(479) 856-2626
(479) 927-1108
Mailing address
4401 SUMMERFIELD CIR, SPRINGDALE, AR 72762-0568
(479) 856-2626
(479) 927-1108
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165825742
—
AR
Enumeration date
05/19/2008
Last updated
05/19/2008
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