Individual
MS. LAGENA KAY IMMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1000 W BUCHANAN ST, CLARKSVILLE, AR 72830-2252
(479) 754-6210
Mailing address
PO BOX 1622, CLARKSVILLE, AR 72830-1622
(479) 754-2107
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR1512
AR
Other
Enumeration date
05/05/2007
Last updated
07/08/2007
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