Cecilia Bonifield
Individual provider Active NPI Occupational Therapy Assistant · Rudy, AR
NPI 1356370548 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1356370548
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA115 (AR)
- Practice address
- 3918 Pecan Grove Rd
Rudy, AR 72952-9026 - Phone
- (479) 632-6337
- Fax
- (479) 632-5916
- NPI assigned
- Jul 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| OTA115 | AR | MD | Occupational Therapy Assistant |
| 192 | OK | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hand Rehabilitation of W. Ark., Inc. | Past | Accepting new patients | |
| Hand Rehabillitation of W. Arkansas, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA115 | AR | Yes |
| Occupational Therapy Assistant | 224Z00000X | 192 | OK |
Addresses
Primary practice location
3918 Pecan Grove Rd
Rudy, AR 72952-9026
Mailing address
113 Teakwood Dr
Poteau, OK 74953-2243
Phone (479) 632-6337
Other providers in Rudy, AR
All providers in Rudy, 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 9, 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.