Provider Demographics
NPI:1780956904
Name:CAMPBELL, CONSTANCE RENEE (OTR/L)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:RENEE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:RENEE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2815 MARY KATHRYN CT
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-9232
Mailing Address - Country:US
Mailing Address - Phone:501-240-9962
Mailing Address - Fax:
Practice Address - Street 1:925 E DIXON RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-4199
Practice Address - Country:US
Practice Address - Phone:501-234-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2253225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist