Individual
AMANDA WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3214 WINCHESTER, BENTON, AR 72015-2929
(501) 794-6482
(501) 794-6483
Mailing address
3214 WINCHESTER, BENTON, AR 72015-2929
(501) 794-6482
(501) 794-6483
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2726
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205964721
—
AR
Enumeration date
09/17/2014
Last updated
05/04/2022
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