Provider Demographics
NPI:1558845651
Name:GREENWOOD, PAIGE (OT-A)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:OT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22461 I 30 STE 301
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-2382
Mailing Address - Country:US
Mailing Address - Phone:501-847-2555
Mailing Address - Fax:
Practice Address - Street 1:22461 I 30 STE 301
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-2382
Practice Address - Country:US
Practice Address - Phone:501-847-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant