Provider Demographics
NPI:1144386350
Name:TODD, JAMI ANNETTE (OTR)
Entity Type:Individual
Prefix:MISS
First Name:JAMI
Middle Name:ANNETTE
Last Name:TODD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1815 BROADMOOR RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4712
Mailing Address - Country:US
Mailing Address - Phone:870-932-9567
Mailing Address - Fax:870-932-9576
Practice Address - Street 1:505 E MATTHEWS AVE STE 205
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3101
Practice Address - Country:US
Practice Address - Phone:870-932-9567
Practice Address - Fax:870-932-9576
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR 455225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist