Provider Demographics
NPI:1558903872
Name:SEATS, MAKENNA (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:MAKENNA
Middle Name:
Last Name:SEATS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:MAKENNA
Other - Middle Name:
Other - Last Name:SEATS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2397 COUNTY ROAD 25
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-7282
Mailing Address - Country:US
Mailing Address - Phone:870-656-9933
Mailing Address - Fax:
Practice Address - Street 1:81 DEVELOPMENT DR
Practice Address - Street 2:
Practice Address - City:YELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72687-7039
Practice Address - Country:US
Practice Address - Phone:870-232-2214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3328225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist