Individual
CAROLINE SLOAN MISCHKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
316 MAIN ST, LAKE VILLAGE, AR 71653
(870) 265-3950
(870) 265-2525
Mailing address
316 MAIN ST, LAKE VILLAGE, AR 71653
(870) 265-3950
(870) 265-2525
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OTR1304
AR
225X00000X
Occupational Therapist
Primary
OTR1304
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167733721
—
AR
Enumeration date
06/16/2008
Last updated
11/24/2020
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