Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OTR2383 | AR |
NPI | 1003152679 |
---|---|
Provider Name | Ms. Whitney Anne Wright |
First Address | Fayetteville, AR 72703-6579 |
Second Address | Fayetteville, AR 72703-6579 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2012 |
Last Update Date | 29/12/2012 |