Joy Susanne Moody, COTA
Individual provider Active NPI Occupational Therapy Assistant · Fordyce, AR
NPI 1124177217 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124177217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- AT-443 (AR)
- Practice address
- 1717 Industrial Dr
Fordyce, AR 71742-7104 - Phone
- (870) 352-7975
- Fax
- (870) 352-8806
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-443 | AR | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Step, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | AT-443 | AR | Yes |
Addresses
Primary practice location
1717 Industrial Dr
Fordyce, AR 71742-7104
Mailing address
RR 1 Box 102
Thornton, AR 71766-9707
Phone (870) 352-8420
Other providers in Fordyce, AR
- John D McIntire
- Melinda McKay
- Cory Andrew McMahon
- Michael D Payne MD PLLC PA
- Youlonda Nix Miller
- Dan Moore
- Patrick Paul Moseley Jr.
- Brianna N Nix
- Janice Nolen
- Samara Nolen
All providers in Fordyce, AR · Occupational Therapy Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.