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General NPI Number Information
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NPI Number | 1295337970
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Entity Type | Individual
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Provider Name | HANA RENE HUNTER
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Gender | Female
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 582 HIGHWAY 365 STE 3
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City | MAYFLOWER
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State | AR
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Zip | 72106-9525
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Country | US
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Telephone | 501-470-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 522 POLK ROAD 127
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City | MENA
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State | AR
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Zip | 71953-7514
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OT2020-088
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License Number State | AR
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