Healthcare Provider Details

I. General information

NPI: 1629190327
Provider Name (Legal Business Name): PHILLIS C WESTERFIELD OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9720 N RODNEY PARHAM RD
LITTLE ROCK AR
72227-6212
US

IV. Provider business mailing address

5300 FERNWOOD RD
LITTLE ROCK AR
72223-9016
US

V. Phone/Fax

Practice location:
  • Phone: 501-228-3868
  • Fax:
Mailing address:
  • Phone: 501-228-3836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR1562
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: