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MS. REGINA GERTRUDE BRANTLEY COTA/L

>> Occupational Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1316203201

Individual Registrant:
MS. REGINA GERTRUDE BRANTLEY COTA/L
Gender: F
Not Sole Proprietor

Location and contact information for practice:
161 SUNRISE CT  MTN HOME, AR 72653 US
Tel: 870-424-0909  Fax: --

Contact information for business:
161 SUNRISE CT  MOUNTAIN HOME, AR 72653-8057 US
Tel: 870-424-0909  Fax: --

Registration Information:
NPI: 1316203201
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant
AROT-A338

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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