Individual provider · Type 1 NPI

Jennie Breanne Tidwell, OTR/L

Occupational Therapist · Carlisle, AR

NPI number 1114159688 Active

Practice location

821 E Park St
Carlisle, AR 72024-9024

Call (870) 552-7110 Map

Fax (870) 552-7115

Mailing address

18 Ponderosa Dr
Lonoke, AR 72086-3603

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000XOTR2314 (AR)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1114159688

Jennie Breanne Tidwell, OTR/L's National Provider Identifier is 1114159688, issued on Aug 18, 2009. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Carlisle, AR. The record was last updated on Jan 11, 2013.