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1356996987
MICAH SELF
BRYANT, AR
NPI
1356996987
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
Enumeration Date
2019-08-09
Last Update Date
2019-08-09
Business Address
MICAH SELF
200 NW 4TH STREET
BRYANT, AR 72022
Phone number:
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Mailing Address
MICAH SELF
7720 SHADY ACRES CIR
HENSLEY, AR 72065-9689
Phone number:
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