Individual
BAYLEE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
42 E MAIN ST, BOONEVILLE, AR 72927-3733
(479) 965-6752
Mailing address
5730 HIGHWAY 60, CHARLESTON, AR 72933-8178
(479) 965-5013
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A2069
AR
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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