Provider Demographics
NPI:1992132955
Name:KIDS POINT THERAPY
Entity type:Organization
Organization Name:KIDS POINT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:MS'CCC-SLP
Authorized Official - Phone:501-412-5621
Mailing Address - Street 1:5704 WISTERIA CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-3556
Mailing Address - Country:US
Mailing Address - Phone:501-412-5621
Mailing Address - Fax:888-472-0526
Practice Address - Street 1:5704 WISTERIA CT
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-3556
Practice Address - Country:US
Practice Address - Phone:501-412-5621
Practice Address - Fax:888-472-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR192513721Medicaid