Provider Demographics
NPI:1275736506
Name:HARVILLE, KATHRYN (COTA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HARVILLE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 CAPERTON LOOP
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-3512
Mailing Address - Country:US
Mailing Address - Phone:479-996-5886
Mailing Address - Fax:479-996-9751
Practice Address - Street 1:521 MAIN ST
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-5109
Practice Address - Country:US
Practice Address - Phone:479-410-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK712224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant