Davinia Archer, MSOTR/L

Individual provider Active NPI Occupational Therapist · Centerton, AR

NPI 1245512235 · NPPES record last updated Sep 15, 2011

Key facts

NPI
1245512235
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
O-T1157 (AR)
Practice address
427 W Centerton Blvd
Centerton, AR 72719-8701
Phone
(479) 795-1260
Fax
(479) 795-1260
NPI assigned
Sep 15, 2011
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
O-T1157ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Imagine Occupational Therapy Services Occupational Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X O-T1157 AR Yes

Addresses

Primary practice location

427 W Centerton Blvd
Centerton, AR 72719-8701

Mailing address

427 W Centerton Blvd
Centerton, AR 72719-8701
Phone (479) 795-1260

Other identifiers

IdentifierTypeStateIssuer
O-T1157OtherARARKANSAS STATE LICENSE

Other providers in Centerton, AR

All providers in Centerton, AR · Occupational Therapist in Arkansas

Sources for this page

Verify at the official NPI Registry.