Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OTR2998 | AR |
NPI | 1003358789 |
---|---|
Provider Name | Mrs. Chelsea Morehead |
First Address | Fayetteville, AR 72704-6283 |
Second Address | Fayetteville, AR 72704-6283 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2016 |
Last Update Date | 10/11/2016 |