NPI 1154797611

Nikki Summerville Stidham, COTAL

Practitioner Occupational Therapy Assistant Berryville, AR

Practice location

Address: 705 W College Ave, Berryville, AR 72616-3105
Phone: (870) 423-6122
Mailing address: 8 Twin Peak Dr, Holiday Island, AR 72631-4233

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence OT-A952 (AR)

Other Occupational Therapy Assistant providers in Arkansas →

Registry record

NPI: 1154797611
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Aug 2015
Record last updated: 9 Jun 2022

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.