Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KATHLEEN MARIE WAGNER, COTA
Active Sole ProprietorKATHLEEN MARIE WAGNER, COTA is a Occupational Therapy Assistant healthcare provider located in PEA RIDGE, Arkansas. NPI 1871879452 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapy Assistant · PEA RIDGE, AR
Registration Details
- NPI Number
- 1871879452
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 27, 2011 (14.792724982955 yrs)
- Last Updated
- Oct 20, 2023
- License
-
OT-A625 (AR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
979 WESTON STPEA RIDGE, AR, 727512628Browse AR providers · Browse ZIP 72751
- Phone
- 4794518181
- Primary Specialty
-
Occupational Therapy Assistant
224Z00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.