Individual
MS. JACQUELYN MARY VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPI
Contact information
Practice address
1005 MAPLE DR, MOUNTAIN VIEW, AR 72560-8999
(870) 269-2110
(870) 269-2923
Mailing address
PO BOX 314, MOUNTAIN VIEW, AR 72560-0314
(870) 656-4572
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OTR1660
AR
225X00000X
Occupational Therapist
Primary
4665
SC
Other
Enumeration date
12/13/2007
Last updated
02/20/2017
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