Individual
MRS. PEGGY MICHELLE MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
765 YELLOW JACKET LANE, CLINTON, AR 72031
(501) 745-6000
Mailing address
26 ARROW RIDGE ROAD, DAMASCUS, AR 72039
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1519
AR
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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