Provider Demographics
NPI:1386016830
Name:CUMMINS, ANNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 NORTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-5293
Mailing Address - Country:US
Mailing Address - Phone:501-791-3331
Mailing Address - Fax:501-791-0294
Practice Address - Street 1:4901 NORTHSHORE DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-5293
Practice Address - Country:US
Practice Address - Phone:501-791-3331
Practice Address - Fax:501-791-0294
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2459225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AROTR2459OtherOT LICENSE