Healthcare Provider Details

I. General information

NPI: 1851066229
Provider Name (Legal Business Name): ZOE L PRICE COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 08/09/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WHITE DR
BATESVILLE AR
72501-2001
US

IV. Provider business mailing address

3307 N 9TH AVE
PARAGOULD AR
72450-9327
US

V. Phone/Fax

Practice location:
  • Phone: 870-569-8120
  • Fax:
Mailing address:
  • Phone: 870-476-6886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOT-A1671
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: