Provider Demographics
NPI:1821301771
Name:CHILD'S PLAY THERAPY SERVICES OF ARKANSAS, PLLC
Entity Type:Organization
Organization Name:CHILD'S PLAY THERAPY SERVICES OF ARKANSAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:870-951-0286
Mailing Address - Street 1:200 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-2860
Mailing Address - Country:US
Mailing Address - Phone:870-305-5188
Mailing Address - Fax:870-305-1038
Practice Address - Street 1:200 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-2860
Practice Address - Country:US
Practice Address - Phone:870-305-5188
Practice Address - Fax:870-305-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1712235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty