Callie Avery Hendricks, MS, OTR/L
Individual provider Active NPI Pediatric Occupational Therapist · Centerton, AR
NPI 1497030969 · NPPES record last updated Oct 17, 2011
Key facts
- NPI
- 1497030969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- License
- OTR2445 (AR)
- Practice address
- 433 W Centerton Blvd
Centerton, AR 72719-8701 - Phone
- (479) 795-1260
- NPI assigned
- Oct 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR2445 | AR | MD | Pediatric Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OTR2445 | AR | Yes |
Addresses
Primary practice location
433 W Centerton Blvd
Centerton, AR 72719-8701
Mailing address
124 Greenfield
Benton, AR 72019-2284
Phone (501) 249-1009
Other providers in Centerton, AR
- Nicole Fortin
- Forward Momentum LLC
- Erbey S Gomez
- Joshua Aaron Hall
- Jessica Lynn Harper
- Erica Hendricks
- Wendy Henson
- Ashley Hines
- Cody Stonewall Hollist
- Willard Howe Howard III
All providers in Centerton, AR · Pediatric Occupational Therapist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2011. 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.