Individual
MRS. JULIE RENEE MARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPY
Contact information
Practice address
1760 N WOODLAND AVE, FAYETTEVILLE, AR 72703-2549
(479) 443-4420
(479) 443-0547
Mailing address
2442 LONGWOOD ST, SPRINGDALE, AR 72762-0580
(479) 750-3064
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NBCOT 1049924
AR
174400000X
Specialist
OTR1619
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W513
BCBS PROVIDER #
AR
Enumeration date
05/10/2006
Last updated
07/09/2007
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