Provider Demographics
NPI:1609032606
Name:PEOPLES, DENISE NICOLE (OTA)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:NICOLE
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:NICOLE
Other - Last Name:DURKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:200 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-3424
Mailing Address - Country:US
Mailing Address - Phone:501-653-5060
Mailing Address - Fax:501-847-5662
Practice Address - Street 1:200 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022
Practice Address - Country:US
Practice Address - Phone:501-653-5060
Practice Address - Fax:501-847-5662
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A527224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant