Individual
MRS. SUSAN WHITNEY ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1500 MUSEUM RD STE 104, CONWAY, AR 72032-4761
(501) 329-3804
(501) 329-0718
Mailing address
1500 MUSEUM RD STE 104, CONWAY, AR 72032-4761
(501) 329-3804
(501) 329-0718
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1779
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1061897
NBCOT
—
01
—
OTR1779
OTR LICENSE
AR
Enumeration date
09/16/2006
Last updated
07/08/2007
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