Healthcare Provider Details

I. General information

NPI: 1053291245
Provider Name (Legal Business Name): BRYNN RHEA CASTLEBERRY OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2025
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11801 FAIRVIEW RD
LITTLE ROCK AR
72212-2406
US

IV. Provider business mailing address

1030 KNOBLE APT 2
CONWAY AR
72034-5056
US

V. Phone/Fax

Practice location:
  • Phone: 501-663-6965
  • Fax:
Mailing address:
  • Phone: 501-213-5563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: