Individual
MRS. LISA G. WREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
12018 HIGHWAY 196, TEXARKANA, AR 71854-1280
(870) 653-4343
Mailing address
1255 HIGHWAY 332, PRESCOTT, AR 71857-9320
(870) 777-6798
(870) 887-6880
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1502
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141437721
—
AR
01
—
OTR1502
STATE LICENSE NUMBER
AR
Enumeration date
12/14/2005
Last updated
09/15/2008
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