Provider Demographics
NPI:1043881493
Name:POND PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:POND PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:POND
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:479-595-2570
Mailing Address - Street 1:1900 S PUMPKIN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-7769
Mailing Address - Country:US
Mailing Address - Phone:479-595-2570
Mailing Address - Fax:
Practice Address - Street 1:599 N CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:WEST FORK
Practice Address - State:AR
Practice Address - Zip Code:72774-2711
Practice Address - Country:US
Practice Address - Phone:479-595-2570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty