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General NPI Number Information
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NPI Number | 1902710197
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Entity Type | Individual
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Provider Name | MAKEELY WADE
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Gender | Female
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 5230 WILLOW CREEK DR STE 101
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City | SPRINGDALE
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State | AR
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Zip | 72762-0898
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Country | US
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Telephone | 501-445-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 881 ROUND TOP ST
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City | PRAIRIE GROVE
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State | AR
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Zip | 72753-4018
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Country | US
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Telephone | 501-286-2565
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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 |
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License Number State | AR
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