Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OTR2115 | AR |
NPI | 1003341900 |
---|---|
Provider Name | Taralee Reeves |
First Address | Benton, AR 72015-2732 |
Second Address | Benton, AR 72015-2732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2017 |
Last Update Date | 08/05/2017 |