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NPI Code Detail

MEDICARE: ADRIANA MAE-LYN MINTON

MEDICARE: ADRIANA MAE-LYN MINTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantAR

General Provider Information

NPI Number : 1871305904
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIANA MAE-LYN MINTON
Provider Business Mailing Address
First Line : 2508 E JOHNSON AVE APT D11
Second Line :
City : JONESBORO
State : AR
Zip : 72405-1951
Country : US
Telephone Number : 573-625-9131
Fax Number :
Provider Business Practice Location Address
First Line : 130 UNDERHILL RD
Second Line :
City : BEEBE
State : AR
Zip : 72012-9751
Country : US
Telephone Number : 501-230-3100
Fax Number : 501-882-9825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2025
Last Update Date : 01/24/2025

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Directions to “ ADRIANA MAE-LYN MINTON ” Practice Location

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