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General NPI Number Information
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NPI Number | 1366860728
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Entity Type | Individual
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Provider Name | AMANDA CAMPBELL
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Gender | Female
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 2510 W HUDSON RD
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City | ROGERS
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State | AR
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Zip | 72756-2072
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Country | US
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Telephone | 479-936-1061
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Fax | 855-812-1132
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Provider Business Mailing Address
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Address Line | 1821 LARKSPUR ST
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City | SPRINGDALE
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State | AR
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Zip | 72764-3015
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Country | US
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Telephone | 479-318-5980
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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 | O-T1409
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OTR2702
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License Number State | AR
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