Individual
ANDREA ROGERS VANHECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190
Mailing address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
OTA-394
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA-394
AR STATE MEDICAL BOARD
AR
Enumeration date
10/02/2014
Last updated
10/02/2014
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