Individual
KELLI BAHENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
605 MENA ST, MENA, AR 71953-3339
(501) 470-3500
Mailing address
605 MENA ST, MENA, AR 71953-3339
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT2022-010
AR
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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