Basic Information
| Provider Information | |||||||||
| NPI: | 1912117581 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HESSE | ||||||||
| FirstName: | VALAREE | ||||||||
| MiddleName: | CONE | ||||||||
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| Credential: | OTRL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 RIVER BLUFF RD | ||||||||
| Address2: | |||||||||
| City: | HEBER SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725438258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013623185 | ||||||||
| FaxNumber: | 5013620879 | ||||||||
| Practice Location | |||||||||
| Address1: | SOUTHRIDGE VILLAGE NURSING AND REHAB | ||||||||
| Address2: | 400 SOUTHRIDGE PARKWAY | ||||||||
| City: | HEBER SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013623185 | ||||||||
| FaxNumber: | 5013629879 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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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 | OTR349 | AR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.