Healthcare Provider Details

I. General information

NPI: 1336051150
Provider Name (Legal Business Name): DANIKA BIRKHEAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 N MAIN ST
SALEM AR
72576-9451
US

IV. Provider business mailing address

120 HERRON RD
ASH FLAT AR
72513-9774
US

V. Phone/Fax

Practice location:
  • Phone: 870-895-6006
  • Fax: 870-277-0896
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOT-A2242
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: