Provider Demographics
NPI:1740599935
Name:ADVANCED SPEECH THERAPY LLC
Entity Type:Organization
Organization Name:ADVANCED SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:TOWNLEY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP, CCC
Authorized Official - Phone:501-960-3400
Mailing Address - Street 1:10014 N RODNEY PARHAM RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-5548
Mailing Address - Country:US
Mailing Address - Phone:501-960-3400
Mailing Address - Fax:
Practice Address - Street 1:10014 N RODNEY PARHAM RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-5548
Practice Address - Country:US
Practice Address - Phone:501-960-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty