Healthcare Provider Details

I. General information

NPI: 1285232942
Provider Name (Legal Business Name): ASHLEY MAFFIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S BLAIR ST
SPRINGDALE AR
72764-4410
US

IV. Provider business mailing address

201 DELLMERE DR
HOT SPRINGS AR
71913-7995
US

V. Phone/Fax

Practice location:
  • Phone: 479-259-2339
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: