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General NPI Number Information
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NPI Number | 1457486987
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Entity Type | Individual
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Provider Name | HEATHER RENEA TAYLOR OTR
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/27/2019
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Provider Practice Location Address
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Address Line | 1004 BEAU TERRE DR
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City | BENTONVILLE
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State | AR
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Zip | 72712-6738
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Country | US
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Telephone | 479-903-1018
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Fax | 855-738-7702
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Provider Business Mailing Address
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Address Line | 14 WEBBLY LN
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City | BELLA VISTA
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State | AR
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Zip | 72714-2909
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Country | US
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Telephone | 479-855-2613
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 2001000598
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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