Individual
MRS. CHASSITY ANN MCCAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
824 SALEM RD, SUITE 220, CONWAY, AR 72034-4821
(501) 932-0055
Mailing address
500 COUNTRY COVE LN, RUSSELLVILLE, AR 72802-1276
(479) 747-5196
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA716
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197940721
—
AR
Enumeration date
09/01/2013
Last updated
09/01/2013
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