Healthcare Provider Details

I. General information

NPI: 1134057011
Provider Name (Legal Business Name): REBECCA PAIGE WOOTTON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3302 N DIXIELAND RD APT C9
ROGERS AR
72756-6840
US

IV. Provider business mailing address

3302 N DIXIELAND RD APT C9
ROGERS AR
72756-6840
US

V. Phone/Fax

Practice location:
  • Phone: 479-459-6115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number27035-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: