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General NPI Number Information
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NPI Number | 1538937685
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Entity Type | Individual
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Provider Name | SKYLAR BREE ANDREWS-ZABEL COTA
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Gender | Female
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 301 W TRIMBLE AVE
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City | BERRYVILLE
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State | AR
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Zip | 72616-3112
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Country | US
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Telephone | 870-423-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 791 COUNTY ROAD 909
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City | GREEN FOREST
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State | AR
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Zip | 72638-3664
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Country | US
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Telephone | 870-654-6294
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OT-A1942
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License Number State | AR
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