Individual
AMANDA STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
908 N REYNOLDS RD, BRYANT, AR 72022-3034
(479) 967-2322
Mailing address
P.O. DRAWER 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A887
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204550721
—
AR
Enumeration date
10/27/2014
Last updated
02/02/2023
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