Individual
BRANDI MICHELLE CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, DOR
Contact information
Practice address
2642 N DUDNEY RD, MAGNOLIA, AR 71753-4305
(870) 234-7000
(870) 234-7168
Mailing address
2231 COLUMBIA ROAD 78, MAGNOLIA, AR 71753-8733
(870) 904-7868
(870) 234-7168
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A629
AR
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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