Individual
ELIZABETH BALDERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2107 DUDLEY ST, TEXARKANA, AR 71854-6345
(870) 772-4427
Mailing address
323 KORNEGAY RD, DE QUEEN, AR 71832-8663
(870) 613-6611
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
215608
TX
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1473
AR
Other
Enumeration date
04/22/2021
Last updated
05/03/2021
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