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Individual

KAY SHORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
170 RUSHFORK CIR, HOT SPRINGS NATIONAL PARK, AR 71913-8576
(501) 538-4546
Mailing address
170 RUSHFORK CIR, HOT SPRINGS NATIONAL PARK, AR 71913-8576
(501) 538-4546

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2053
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000227851
AZ STATE DES CMDP
AZ
01
189208700
DOL OWCP
AZ
01
1Z6798
HEALTH NET
AZ
01
26144
MEDICARE GROUP ID
AZ
01
64-00187
UNITED HEALTH PLAN
AZ
05
643800
AZ
01
AZ0295990
BCBS AZ
AZ
01
F02383
PHOENIX HEALTH PLAN
AZ
Enumeration date
05/31/2005
Last updated
02/21/2026
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