Provider Demographics
NPI:1932321502
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:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTAH
Authorized Official - Middle Name:
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:
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 Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty