Provider Demographics
NPI:1639740152
Name:JUMPER, SARIKA GNEISS (OT)
Entity type:Individual
Prefix:
First Name:SARIKA
Middle Name:GNEISS
Last Name:JUMPER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:SARIKA
Other - Middle Name:GNEISS
Other - Last Name:MAYMOUNDOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2323 W CHESTNUT ST STE 6
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3520
Mailing Address - Country:US
Mailing Address - Phone:479-346-5459
Mailing Address - Fax:
Practice Address - Street 1:2323 W CHESTNUT ST STE 6
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3520
Practice Address - Country:US
Practice Address - Phone:479-346-5459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist