Provider Demographics
NPI:1316464423
Name:HILL COUNTRY THERAPY
Entity type:Organization
Organization Name:HILL COUNTRY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRYSTLE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:501-209-4026
Mailing Address - Street 1:1 ALAMITO LN
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71909-3057
Mailing Address - Country:US
Mailing Address - Phone:870-448-6687
Mailing Address - Fax:
Practice Address - Street 1:3901 N HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71909-9604
Practice Address - Country:US
Practice Address - Phone:501-209-4026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP3045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty