Organization
MENDING WINGS DEVELOPMENTAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD CHAD SULLIVAN (PRESIDENT)
(479) 283-0024
Entity
Organization
Contact information
Practice address
4066 N CAMBRAY DR, FAYETTEVILLE, AR 72703-5049
(479) 283-0024
Mailing address
4066 N CAMBRAY DR, FAYETTEVILLE, AR 72703-5049
(479) 283-0024
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
02/19/2007
Last updated
08/22/2020
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