Healthcare Provider Details

I. General information

NPI: 1518154764
Provider Name (Legal Business Name): TARA LOUISA GARNER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 MARKET PLACE AVE STE 400
BRYANT AR
72022-8077
US

IV. Provider business mailing address

600 S MCKINLEY ST SUITE 210
LITTLE ROCK AR
72205-5202
US

V. Phone/Fax

Practice location:
  • Phone: 501-943-1681
  • Fax: 501-439-1682
Mailing address:
  • Phone: 501-664-4088
  • Fax: 501-978-2765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number234991
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2153
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: