Individual
LARISSA MAYTE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
502 E RACE AVE, SEARCY, AR 72143-4417
(870) 336-8100
Mailing address
3127 SOUTHWEST DR, JONESBORO, AR 72404-8404
(870) 336-8100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1926
AR
Other
Enumeration date
04/03/2023
Last updated
03/05/2025
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