Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0TR999 | AR |
NPI | 1346494960 |
---|---|
Provider Name | Ms. Maude Ann Carter |
First Address | Little Rock, AR 72205-7202 |
Second Address | Little Rock, AR 72205-7202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2008 |
Last Update Date | 10/11/2008 |