Individual
JENNIFER HAVARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
360 OUACHITA 69, SMACKOVER, AR 71762-9607
(870) 807-4087
Mailing address
360 OUACHITA 69, SMACKOVER, AR 71762-9607
(870) 807-4087
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A541
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177298721
—
AR
Enumeration date
07/23/2009
Last updated
07/23/2009
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