Individual
ABAGAIL GRACE REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
121 MAIN ST, WEST FORK, AR 72774-3119
(815) 922-1597
Mailing address
PO BOX 1095, WEST FORK, AR 72774-1095
(815) 922-1597
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1959
AR
Other
Enumeration date
08/17/2023
Last updated
12/07/2023
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