Amanda Gail Escue, BCBA, MCD, CCC-SLP
Individual provider Active NPI Behavior Analyst · Bono, AR
NPI 1497964894 · NPPES record last updated Aug 2, 2023
Key facts
- NPI
- 1497964894
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- BACB732936 (AR)
- Practice address
- 677 Highway 91 W
Bono, AR 72416-8127 - Phone
- (870) 219-1027
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB732936 | AR | MD | Behavioral Analyst |
| 2316 | AR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heritage Therapy, L.L.C. | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BACB732936 | AR | Yes |
| Speech-Language Pathologist | 235Z00000X | 2316 | AR |
Addresses
Primary practice location
677 Highway 91 W
Bono, AR 72416-8127
Mailing address
677 Highway 91 W
Bono, AR 72416-8127
Phone (870) 219-1027
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163605721 | Medicaid | AR |
Other providers in Bono, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.