Individual
KENZLEY MALONE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
948 COUNTY ROAD 113, BONO, AR 72416-8299
(870) 219-5534
(870) 203-9335
Mailing address
16532 HIGHWAY 18 E, BLACK OAK, AR 72414-9611
(870) 243-6990
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
09/03/2021
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