Individual
LYNETTE MENNA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2474 E JOYCE BLVD, SUITE 2, FAYETTEVILLE, AR 72703-4519
(479) 521-8326
(479) 521-5439
Mailing address
2474 E JOYCE BLVD, SUITE 2, FAYETTEVILLE, AR 72703-4519
(479) 521-8326
(479) 521-5439
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR1370
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W679
BLUE CROSS BLUE SHEILD
AR
Enumeration date
05/11/2006
Last updated
07/08/2007
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