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Individual

MRS. CODI C OLIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
1675 W. JEFFERSON, STE A, SILOAM SPRINGS, AR 72761
(479) 524-8028
(479) 524-6151
Mailing address
PO BOX 1379, SILOAM SPRINGS, AR 72761-1379
(479) 524-8028
(479) 524-6151

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1488
OK
225X00000X
Occupational Therapist
OTR2061
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1488
STATE LICENSE
OK
01
OTR2061
ARKANSAS STATE MEDICAL BO
AR
Enumeration date
07/26/2006
Last updated
09/07/2007
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