Healthcare Provider Details

I. General information

NPI: 1225386881
Provider Name (Legal Business Name): DUBWIG THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6453 STEPHANIE COVE
HARRISON AR
72601-5591
US

IV. Provider business mailing address

6453 STEPHANIE COVE
HARRISON AR
72601-5591
US

V. Phone/Fax

Practice location:
  • Phone: 870-391-9912
  • Fax:
Mailing address:
  • Phone: 870-391-9912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTR1332
License Number StateAR

VIII. Authorized Official

Name: MRS. PATRICIA LYNN DUBWIG
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 870-391-9912