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Individual

MRS. KATHY D ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTAL

Contact information

Practice address
HIGHWAY 10 AT DETROIT, DANVILLE, AR 72833
(479) 495-6326
(479) 495-3336
Mailing address
10417 MADDIE ROAD, DARDANELLE, AR 72834
(479) 495-6326
(479) 495-3336

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139368721
AR
01
256020
NBCOT
AR
01
O-T0937
STATE LIC
AR
Enumeration date
04/30/2007
Last updated
09/22/2009
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