MEDICARE: LASHONNA FAITH DAWNTA-COOPER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA4906	AR

General Provider Information

NPI Number	:	1386522449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHONNA FAITH DAWNTA-COOPER

Provider Business Mailing Address
First Line	:	2029 HEMPSTEAD 35 N
Second Line	:
City	:	OZAN
State	:	AR
Zip	:	71855-9087
Country	:	US
Telephone Number	:	870-557-2265
Fax Number	:

Provider Business Practice Location Address
First Line	:	3432 JEFFERSON AVE
Second Line	:
City	:	TEXARKANA
State	:	AR
Zip	:	71854-2747
Country	:	US
Telephone Number	:	870-330-3088
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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