Provider Demographics
NPI:1558702688
Name:MCKOWN, TOMMIE ARIKA (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:TOMMIE
Middle Name:ARIKA
Last Name:MCKOWN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 VICTORY LN
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-7781
Mailing Address - Country:US
Mailing Address - Phone:479-799-6398
Mailing Address - Fax:
Practice Address - Street 1:224 NORTH ST
Practice Address - Street 2:
Practice Address - City:CAVE CITY
Practice Address - State:AR
Practice Address - Zip Code:72521-9799
Practice Address - Country:US
Practice Address - Phone:870-292-3214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1422224Z00000X
AROTR3603225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant