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Individual

MRS. LISA DENISE CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR L

Contact information

Practice address
407 CARSON ST, HOT SPRINGS, AR 71901-6852
(501) 620-5509
Mailing address
212 SUMMER ST, HOT SPRINGS, AR 71913
(501) 844-5339

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1772
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
148144721
AR
01
5X819
BLUE CROSS
AR
Enumeration date
09/29/2006
Last updated
05/02/2014
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