Provider Demographics
NPI:1265733570
Name:THE NATURAL STATE OF WELLNESS, INC
Entity type:Organization
Organization Name:THE NATURAL STATE OF WELLNESS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:ALANIZ
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:479-381-3709
Mailing Address - Street 1:4606 HIGHLAND KNOLLS RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8869
Mailing Address - Country:US
Mailing Address - Phone:479-381-3709
Mailing Address - Fax:479-936-5969
Practice Address - Street 1:599 N CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:WEST FORK
Practice Address - State:AR
Practice Address - Zip Code:72774-2711
Practice Address - Country:US
Practice Address - Phone:479-839-8542
Practice Address - Fax:479-839-2237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR874225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty