Individual
MRS. JORDAN HERWALDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT-A
Contact information
Practice address
851 S DOGWOOD ST, SILOAM SPRINGS, AR 72761-3915
(479) 220-5361
Mailing address
851 S DOGWOOD ST, SILOAM SPRINGS, AR 72761-3915
(479) 220-5361
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
O-T1078
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O-T1078
OT-A LICENSE
AR
Enumeration date
03/22/2011
Last updated
07/29/2024
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