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Individual

JORDAN LEIGH SHY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
910 NW 7TH ST, BENTONVILLE, AR 72712-4565
(479) 250-9838
Mailing address
2275 N BLUE MESA DR, FAYETTEVILLE, AR 72703-9382
(479) 935-6654

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2019-007
AR

Other

Enumeration date
08/14/2019
Last updated
11/27/2023
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