Individual
MRS. ASHLEY NICOLE WEBSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
804 N YOCUM AVE APT 121, EL DORADO, AR 71730-4369
(870) 312-2561
Mailing address
804 N YOCUM AVE APT 121, EL DORADO, AR 71730-4369
(870) 312-2561
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OT-A688
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191536721
—
AR
Enumeration date
05/22/2012
Last updated
05/22/2012
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