Individual
JESSICA ANN WALTHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT-A
Contact information
Practice address
316 MAIN ST., LAKE VILLAGE, AR 71653
(870) 265-3950
(870) 265-2525
Mailing address
316 MAIN ST., LAKE VILLAGE, AR 71653
(870) 265-3950
(870) 265-2525
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OT0864
AR
224Z00000X
Occupational Therapy Assistant
Primary
OTA543
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172433721
—
AR
Enumeration date
12/10/2008
Last updated
11/24/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us