Individual
HOLLY KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 EDGEWOOD DR, MAUMELLE, AR 72113-6267
(501) 803-9722
Mailing address
405 EDGEWOOD DR, MAUMELLE, AR 72113-6267
(501) 803-9722
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OTR3287
AR
225XP0200X
Pediatric Occupational Therapist
Primary
OTR3287
AR
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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