Basic Information
| Provider Information | |||||||||
| NPI: | 1043430432 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DARNELL | ||||||||
| FirstName: | BAMBI | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2512 13TH AVENUE WEST | ||||||||
| Address2: | |||||||||
| City: | JASPER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2052753582 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4330 HIGHWAY 78 | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | JASPER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2052952434 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 1989 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.