Provider Demographics
NPI:1558091199
Name:VERMILLION, AUBREY (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:
Last Name:VERMILLION
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 1:8070 N TILLYS HILL RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AR
Mailing Address - Zip Code:72722-9622
Mailing Address - Country:US
Mailing Address - Phone:479-802-8446
Mailing Address - Fax:
Practice Address - Street 1:650 S DODSON RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-7015
Practice Address - Country:US
Practice Address - Phone:479-271-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1348224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant