Healthcare Provider Details

I. General information

NPI: 1932012879
Provider Name (Legal Business Name): CHLOE ANN MARTIN COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 EMERALD DR
MAUMELLE AR
72113-6040
US

IV. Provider business mailing address

82 EMERALD DR
MAUMELLE AR
72113-6040
US

V. Phone/Fax

Practice location:
  • Phone: 501-847-5600
  • Fax:
Mailing address:
  • Phone: 501-847-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOT-A2229
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: