Individual
MISS MIKAYLA LEE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5532 JFK BLVD, NORTH LITTLE ROCK, AR 72116-6708
(501) 588-3211
Mailing address
5532 JFK BLVD, NORTH LITTLE ROCK, AR 72116-6708
(501) 588-3211
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1862
AR
Other
Enumeration date
08/05/2022
Last updated
08/08/2022
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