Individual
MRS. TARA NICOLE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1905 W BEEBE CAPPS EXPY, SEARCY, AR 72143-5012
(501) 268-5001
(501) 268-5443
Mailing address
1905 W BEEBE CAPPS EXPY, SEARCY, AR 72143-5012
(501) 268-5001
(501) 268-5443
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
O-T0855
AR
Other
Enumeration date
09/17/2008
Last updated
09/17/2008
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