Healthcare Provider Details

I. General information

NPI: 1790410645
Provider Name (Legal Business Name): CHANDLER PAIGE BEWLEY MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHANDLER PAIGE KERR

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 MCKENZIE RD
SPRINGDALE AR
72762-0747
US

IV. Provider business mailing address

6200 WATKINS AVE APT F105
SPRINGDALE AR
72762-3134
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-7778
  • Fax:
Mailing address:
  • Phone: 951-491-5524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT22938
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR3656
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: