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General NPI Number Information
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NPI Number | 1871305904
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Entity Type | Individual
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Provider Name | ADRIANA MAE-LYN MINTON
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Gender | Female
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 130 UNDERHILL RD
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City | BEEBE
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State | AR
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Zip | 72012-9751
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Country | US
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Telephone | 501-230-3100
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Fax | 501-882-9825
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Provider Business Mailing Address
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Address Line | 2508 E JOHNSON AVE APT D11
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City | JONESBORO
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State | AR
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Zip | 72405-1951
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Country | US
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Telephone | 573-625-9131
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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 |
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License Number State | AR
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