Individual
TAMMY BENNETT
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
PO DRAWER 2109, RUSSELLVILLE, AR 72802
(479) 967-2322
(479) 967-9876
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2318
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180123721
—
AR
Enumeration date
02/11/2010
Last updated
01/03/2023
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