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General NPI Number Information
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NPI Number | 1063223865
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Entity Type | Individual
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Provider Name | ADRIANN JADE WATSON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 1004 S MAIN ST
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City | BERRYVILLE
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State | AR
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Zip | 72616-4330
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Country | US
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Telephone | 870-654-3869
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Fax | 870-505-2016
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Provider Business Mailing Address
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Address Line | 2624 HIGHWAY 206 E
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City | HARRISON
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State | AR
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Zip | 72601-7040
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Country | US
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Telephone | 870-754-4698
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2025-007
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License Number State | AR
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