Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1023314267 |
---|---|
Provider Name | Erica Leigh Ann Harguess |
First Address | Jonesboro, AR 72401-8146 |
Second Address | Jonesboro, AR 72401-8146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2011 |
Last Update Date | 06/02/2011 |