Individual
TAMMY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
8109 INTERSTATE 30, LITTLE ROCK, AR 72209-4840
(501) 562-5400
(501) 562-8577
Mailing address
101 VENEZIA LN, MAUMELLE, AR 72113-7458
(501) 319-2668
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
O-T1410
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203022721
—
AR
Enumeration date
06/02/2014
Last updated
03/02/2016
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