Provider Demographics
NPI:1861193484
Name:JANNA L HINES THERAPY SERVICES LLC
Entity type:Organization
Organization Name:JANNA L HINES THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:479-544-2734
Mailing Address - Street 1:3104 NE 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3717
Mailing Address - Country:US
Mailing Address - Phone:479-544-2734
Mailing Address - Fax:855-975-2995
Practice Address - Street 1:201 SW 14TH ST STE 205
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7771
Practice Address - Country:US
Practice Address - Phone:479-544-2734
Practice Address - Fax:855-975-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty