Provider Demographics
NPI:1760847222
Name:PIERCE, CHRISTY (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 STONEYKIRK DR
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-3608
Mailing Address - Country:US
Mailing Address - Phone:417-592-2293
Mailing Address - Fax:
Practice Address - Street 1:1601 GREENHOUSE RD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72713-9292
Practice Address - Country:US
Practice Address - Phone:479-795-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011027723225X00000X
AROTR2687225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist