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General NPI Number Information
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NPI Number | 1760195986
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Entity Type | Individual
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Provider Name | ALEAH KAY WILKERSON COTA/L
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Gender | Female
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Dates
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Enumeration Date | 01/03/2023
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 1501 S WALDRON RD STE 107
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City | FORT SMITH
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State | AR
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Zip | 72903-2568
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Country | US
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Telephone | 479-329-1471
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 PARK AVE
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City | FORT SMITH
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State | AR
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Zip | 72903-2130
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Country | US
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Telephone | 479-650-2701
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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 | 0131-002766
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License Number State | VA
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