Individual
LILLY BICKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
23 PARKCLIFF DR, HOLIDAY ISLAND, AR 72631-9230
(479) 363-6422
Mailing address
23 PARKCLIFF DR, HOLIDAY ISLAND, AR 72631-9230
(479) 363-6422
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT-A1593
STATE LICENSE
AR
Enumeration date
03/04/2020
Last updated
03/04/2020
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