Individual
KELLI KOTLARZ RAWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.TR/L
Contact information
Practice address
2400 W MAIN ST, JACKSONVILLE, AR 72076
(501) 982-4578
(501) 533-6326
Mailing address
6720 WAVERLY DRIVE, LITTLE ROCK, AR 72207
(501) 944-3420
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR1972
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156333721
—
AR
Enumeration date
02/22/2007
Last updated
12/23/2021
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