Individual
MRS. SUSAN RENEE BLAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
207 FRED RAINS DR, SHERWOOD, AR 72120-5457
(501) 834-0217
Mailing address
207 FRED RAINS DR, SHERWOOD, AR 72120-5457
(501) 834-0217
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
854
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127882721
—
AR
Enumeration date
10/22/2008
Last updated
10/22/2008
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