Provider Demographics
NPI:1679895270
Name:HINSON, CRISTIN AMBER (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:CRISTIN
Middle Name:AMBER
Last Name:HINSON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CRISTIN
Other - Middle Name:AMBER
Other - Last Name:LOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:5532 JFK BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-6708
Mailing Address - Country:US
Mailing Address - Phone:501-551-1250
Mailing Address - Fax:501-353-2599
Practice Address - Street 1:5532 JFK BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-6708
Practice Address - Country:US
Practice Address - Phone:501-588-3211
Practice Address - Fax:501-353-2599
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2308225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR181050721Medicaid