Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | OTR2810 | AR |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OTR2810 | AR |
NPI | 1174999692 |
---|---|
Provider Name | Mrs. Allison Pribble Doan |
First Address | Wynne, AR 72396-2540 |
Second Address | Wynne, AR 72396-2024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2015 |
Last Update Date | 19/08/2015 |