Healthcare Provider Details

I. General information

NPI: 1386002061
Provider Name (Legal Business Name): ASHLEY BARKLEY OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 LENTZ RD
MORRILTON AR
72110-3740
US

IV. Provider business mailing address

259 HIGHWAY 285 N
DAMASCUS AR
72039-9015
US

V. Phone/Fax

Practice location:
  • Phone: 105-135-4117
  • Fax: 501-354-0095
Mailing address:
  • Phone: 479-461-7914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR2882
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: