Provider Demographics
NPI:1467754630
Name:PEARSON, DOROTHY ELAINE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:ELAINE
Last Name:PEARSON
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 1:409 FOREST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:AR
Mailing Address - Zip Code:71861
Mailing Address - Country:US
Mailing Address - Phone:870-904-1309
Mailing Address - Fax:
Practice Address - Street 1:500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-5206
Practice Address - Country:US
Practice Address - Phone:870-777-4501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTA-595224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant