Individual
MRS. ANGELA SUZANNE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3801 JOHNSON MILL BLVD, FAYETTEVILLE, AR 72704-5297
(479) 856-6400
Mailing address
3099 EAGLECREST CIR, SPRINGDALE, AR 72762-8093
(479) 466-8651
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-A1238
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT-A1238
COTA
AR
Enumeration date
08/08/2017
Last updated
08/08/2017
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