Provider Demographics
NPI:1487026860
Name:MCKAY, CAITLIN (COTA)
Entity Type:Individual
Prefix:MISS
First Name:CAITLIN
Middle Name:
Last Name:MCKAY
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 1:207 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:AR
Mailing Address - Zip Code:72958-9233
Mailing Address - Country:US
Mailing Address - Phone:479-227-1194
Mailing Address - Fax:479-582-2746
Practice Address - Street 1:48 W COLT SQUARE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2813
Practice Address - Country:US
Practice Address - Phone:479-582-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1028224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant