NPI 1053621201

Melissa Marie Tietze, COTA

Practitioner Occupational Therapy Assistant Benton, AR

Practice location

Address: 17706 I-30 STE 3, Benton, AR 72019-2930
Phone: (501) 315-4414
Fax: (501) 315-3467

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence OT-A869 (AR)

Other Occupational Therapy Assistant providers in Arkansas →

Registry record

NPI: 1053621201
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Oct 2010
Record last updated: 19 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.