Provider Demographics
NPI:1225250897
Name:STEPHENS SPEECH CLINIC PA
Entity Type:Organization
Organization Name:STEPHENS SPEECH CLINIC PA
Other - Org Name:THERAPY LEARNING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EUPHAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:870-741-0500
Mailing Address - Street 1:200 HIGHWAY 43 E
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-2116
Mailing Address - Country:US
Mailing Address - Phone:870-741-0500
Mailing Address - Fax:870-741-6196
Practice Address - Street 1:200 HIGHWAY 43 E
Practice Address - Street 2:SUITE 7
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2116
Practice Address - Country:US
Practice Address - Phone:870-741-0500
Practice Address - Fax:870-741-6196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR408225100000X
AR1152225X00000X
AR714235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty