Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OTR2885 | AR |
N | 225XH1200X | Occupational Therapist - Hand | OTR2885 | AR |
N | 2251H1300X | Human Factors | OTR2885 | AR |
N | 225XH1300X | Human Factors | OTR2885 | AR |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OTR2885 | AR |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OTR2885 | AR |
NPI | 1659803864 |
---|---|
Provider Name | Mrs. Amanda Michelle West |
First Address | Little Rock, AR 72205-7101 |
Second Address | Little Rock, AR 72205-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2017 |
Last Update Date | 28/03/2017 |