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General NPI Number Information
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NPI Number | 1356597736
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Entity Type | Individual
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Provider Name | JACQUELINE WOLFE SUMLER MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/17/2008
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Last Update Date | 04/07/2021
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Provider Practice Location Address
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Address Line | 207 FRED RAINS DR
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City | SHERWOOD
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State | AR
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Zip | 72120-5457
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Country | US
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Telephone | 591-834-0217
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Fax |
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Provider Business Mailing Address
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Address Line | 8895 HIGHWAY 319 W
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City | AUSTIN
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State | AR
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Zip | 72007-9301
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Country | US
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Telephone | 501-912-1826
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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 | OTR226
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License Number State | AR
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