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Individual

SUSAN R BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
11900 KANIS RD, STE. D-2, LITTLE ROCK, AR 72211-3733
(501) 687-0851
(501) 687-0853
Mailing address
11900 KANIS RD, STE. D-2, LITTLE ROCK, AR 72211-3733
(501) 687-0851
(501) 687-0853

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR1520
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5X525
BLUE CROSS BLUE SHIELD
AR
Enumeration date
02/02/2007
Last updated
07/09/2007
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