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General NPI Number Information
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NPI Number | 1972636280
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Entity Type | Individual
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Provider Name | ALISHA TODD OTR.L
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3450 W 34TH AVE
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City | PINE BLUFF
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State | AR
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Zip | 71603-5508
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Country | US
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Telephone | 870-534-7392
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Fax | 870-534-7297
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Provider Business Mailing Address
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Address Line | 508 WINCHESTER AVE
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City | WHITE HALL
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State | AR
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Zip | 71602-2730
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Country | US
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Telephone | 870-534-7392
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Fax | 870-534-7297
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1870
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License Number State | AR
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