Healthcare Provider Details

I. General information

NPI: 1174079453
Provider Name (Legal Business Name): ISAACS OCCUPATIONAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 COURT RD
ASH FLAT AR
72513
US

IV. Provider business mailing address

PO BOX 115
ASH FLAT AR
72513-0115
US

V. Phone/Fax

Practice location:
  • Phone: 870-710-0377
  • Fax: 870-994-2372
Mailing address:
  • Phone: 870-710-0377
  • Fax: 870-994-2372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTR524
License Number StateAR

VIII. Authorized Official

Name: MRS. MELANIE ANN ISAACS
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 870-710-0377