Individual
MRS. AMANDA KAY MITCHELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
17706 I30, SUITE 3, BENTON, AR 72015
(501) 315-4414
(501) 315-3467
Mailing address
17706 I30, SUITE 3, BENTON, AR 72015
(501) 315-4414
(501) 315-3467
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1545
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50650
—
AR
Enumeration date
05/15/2006
Last updated
07/08/2007
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