Provider Demographics
NPI:1437292414
Name:MOUNTIAN PINE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MOUNTIAN PINE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:501-767-2421
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN PINE
Mailing Address - State:AR
Mailing Address - Zip Code:71956-0001
Mailing Address - Country:US
Mailing Address - Phone:501-767-2421
Mailing Address - Fax:501-767-1549
Practice Address - Street 1:690 BLAKELY DAM ROAD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN PINE
Practice Address - State:AR
Practice Address - Zip Code:71956-0001
Practice Address - Country:US
Practice Address - Phone:501-767-2421
Practice Address - Fax:501-767-1549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1220235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty