Provider Demographics
NPI:1457077042
Name:STEPHENS-WILLIAMS, KIMBERLY (OTR/L)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:STEPHENS-WILLIAMS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 SPEERS CIR
Mailing Address - Street 2:
Mailing Address - City:JESSIEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71949-9288
Mailing Address - Country:US
Mailing Address - Phone:501-622-9283
Mailing Address - Fax:
Practice Address - Street 1:2607 ALBERT PIKE RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4501
Practice Address - Country:US
Practice Address - Phone:501-760-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR501225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist