Provider Demographics
NPI:1033348099
Name:BEAUCHAMP, DAMON JAMES (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:DAMON
Middle Name:JAMES
Last Name:BEAUCHAMP
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:AR
Mailing Address - Zip Code:72855-4924
Mailing Address - Country:US
Mailing Address - Phone:479-963-6151
Mailing Address - Fax:479-963-6331
Practice Address - Street 1:1414 S ELM ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:AR
Practice Address - Zip Code:72855-4924
Practice Address - Country:US
Practice Address - Phone:479-963-6151
Practice Address - Fax:479-963-6331
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2022-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1953225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist