Provider Demographics
NPI:1467660720
Name:ARKANSAS OCCUPATIONAL THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:ARKANSAS OCCUPATIONAL THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTRL
Authorized Official - Phone:479-264-6202
Mailing Address - Street 1:55 VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:AR
Mailing Address - Zip Code:72837-8999
Mailing Address - Country:US
Mailing Address - Phone:479-264-6202
Mailing Address - Fax:
Practice Address - Street 1:55 VIRGINIA DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:AR
Practice Address - Zip Code:72837-8999
Practice Address - Country:US
Practice Address - Phone:479-264-6202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1790225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty