Organization Name: | BRANCH THERAPY, PLLC |
NPI Number: | 1922469246 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MITCHELL D BARKER (ORGANIZER-INCORPORATOR/ CCC-SLP) |
Mailing Address: | 1202 Ne Mcclain Rd Bentonville |
State: | AR US |
Postal Code: | 727123875 |
Phone Number: | 6162555660 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2016 |
NPI Last Update Date: | 05/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP#4018 |
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 |