| Organization Name: | PERSONAL THERAPY OF NORTHEAST ARKANSAS, INC. |
| NPI Number: | 1053361477 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GINA RENEA DEUTER (OWNER/SPEECH PATHOLOGIST) |
| Mailing Address: | 2917 King St Suite A Jonesboro |
| State: | AR US |
| Postal Code: | 724015322 |
| Phone Number: | 8709749114 |
| Fax Number: | 8709749184 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP#1713 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |