Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OT-A1642 | AR |
NPI | 1023618915 |
---|---|
Provider Name | Rachel Erin Columbus |
First Address | Sherwood, AR 72120-2981 |
Second Address | Sherwood, AR 72120-2981 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2020 |
Last Update Date | 29/10/2020 |