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General NPI Number Information
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NPI Number | 1518440627
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Entity Type | Individual
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Provider Name | KAYLA ROBERTS COTA
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Gender | Female
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 806 W COLLEGE AVE
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City | BERRYVILLE
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State | AR
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Zip | 72616-3107
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Country | US
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Telephone | 870-423-3124
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Fax |
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Provider Business Mailing Address
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Address Line | 8386 KERNODLE LN
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City | HARRISON
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State | AR
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Zip | 72601-1973
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Country | US
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Telephone | 870-416-4038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT-A1260
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License Number State | AR
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