Healthcare Provider Details

I. General information

NPI: 1215082912
Provider Name (Legal Business Name): KARI WALDEN COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WILSON LOOP
WARD AR
72176-8656
US

IV. Provider business mailing address

5532 JFK BLVD
NORTH LITTLE ROCK AR
72116-6708
US

V. Phone/Fax

Practice location:
  • Phone: 501-588-3211
  • Fax: 501-843-2270
Mailing address:
  • Phone: 501-588-3211
  • Fax: 501-353-2599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberO-T0652
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOT-A486
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: