Provider Demographics
NPI:1073054318
Name:BROWN, KAYLEE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SIOUX DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:AR
Mailing Address - Zip Code:72007-9635
Mailing Address - Country:US
Mailing Address - Phone:501-269-9629
Mailing Address - Fax:
Practice Address - Street 1:26 SIOUX DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:AR
Practice Address - Zip Code:72007
Practice Address - Country:US
Practice Address - Phone:501-269-9629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A899224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant