Provider Demographics
NPI:1922160928
Name:GILMAN, KAREN MARIE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MARIE
Last Name:GILMAN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:BACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:228 POINTER TRL W
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-2266
Mailing Address - Country:US
Mailing Address - Phone:479-474-5276
Mailing Address - Fax:
Practice Address - Street 1:228 POINTER TRL W
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-2266
Practice Address - Country:US
Practice Address - Phone:479-474-5276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR506225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AROTR506OtherLICENSE