Individual
LACEY MICHELLE MEDLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5112 HARRINGTON DRIVE, UNIONTOWN, AR 72955-6932
(479) 719-0906
Mailing address
2207 PARK AVE, VAN BUREN, AR 72956-6932
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1434
AR
Other
Enumeration date
01/03/2019
Last updated
05/02/2024
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