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Individual

TINA CHUNG HODGES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
2200 BRUCE ST STE 101, CONWAY, AR 72034-6108
(501) 470-7457
(501) 504-2105
Mailing address
2200 BRUCE ST STE 101, CONWAY, AR 72034-6108
(501) 470-7457
(501) 504-2105

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
O-T0958
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
180268721
AR
Enumeration date
09/03/2009
Last updated
01/31/2025
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