Individual
TONI CONVILLE REDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 REMINGTON DR, LITTLE ROCK, AR 72204-8202
(501) 850-8788
(501) 850-8791
Mailing address
203 HIDDEN VALLEY LOOP, MAUMELLE, AR 72113-6785
(501) 850-8788
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1056
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143786721
—
AR
01
—
5U520
BCBS
AR
Enumeration date
01/17/2007
Last updated
08/08/2012
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