Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OTR604 | AR |
NPI | 1003949066 |
---|---|
Provider Name | Mrs. Barbara Jean Wilson |
First Address | Little Rock, AR 72211-3606 |
Second Address | Little Rock, AR 72205-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 31/08/2021 |