Individual
ALICIA ANN WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
1373 HIGHWAY 10 W, PERRY, AR 72125-8005
(501) 662-4145
Mailing address
1373 HIGHWAY 10 W, PERRY, AR 72125-8005
(501) 662-4145
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR1148
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5T631
BLUE CROSS BLUE SHEILD #
AR
Enumeration date
09/04/2006
Last updated
07/09/2007
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