Individual
AVA ROSE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 S BLAIR ST, SPRINGDALE, AR 72764-4410
(479) 259-2339
Mailing address
1223 N HAVEN DR APT 403, FAYETTEVILLE, AR 72703-1010
(501) 303-7898
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
516529
AR
Other
Enumeration date
08/17/2024
Last updated
08/17/2024
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