Individual
CHRISTINE DEKENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3801 JOHNSON MILL BLVD STE B, FAYETTEVILLE, AR 72704-6364
(479) 856-6400
(479) 856-6623
Mailing address
3801 JOHNSON MILL BLVD STE B, FAYETTEVILLE, AR 72704-6364
(479) 856-6400
(479) 856-6623
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2683
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTR2683
ARKANSAS STATE LICENSE
AR
Enumeration date
12/11/2013
Last updated
12/11/2013
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