Healthcare Provider Details

I. General information

NPI: 1083843486
Provider Name (Legal Business Name): AMY SUE TROBIS O.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 HWY 64 W
BEEBE AR
72012-2094
US

IV. Provider business mailing address

130 UNDERHILL RD
BEEBE AR
72012-9751
US

V. Phone/Fax

Practice location:
  • Phone: 501-882-6660
  • Fax: 501-882-9825
Mailing address:
  • Phone: 501-882-6660
  • Fax: 501-882-9825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: