Individual
JENNIFER WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
808 S 52ND ST, ROGERS, AR 72758-8602
(479) 587-1700
Mailing address
3232 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4005
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12947
MA
225XP0019X
Physical Rehabilitation Occupational Therapist
06596
MD
225XP0019X
Physical Rehabilitation Occupational Therapist
OTR2857
AR
Other
Enumeration date
01/26/2016
Last updated
06/03/2021
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