Individual
MS. JULIE GOGGINS BRAZIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPI
Contact information
Practice address
1500 WILSON LOOP, WARD, AR 72176
(501) 941-5630
Mailing address
1434 FERN CREEK CIRCLE, BENTON, AR 72019-9609
(501) 772-6667
(501) 221-3870
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR503
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120324721
—
AR
01
—
5X311
BLUE CROSS BLUE SHIELD
AR
05
—
OTR503
—
AR
Enumeration date
02/07/2007
Last updated
11/08/2023
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