Provider Demographics
NPI:1578161311
Name:GATLIFF, ANNA MARIE (COTA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:GATLIFF
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 1:784 BILLSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DELIGHT
Mailing Address - State:AR
Mailing Address - Zip Code:71940-8190
Mailing Address - Country:US
Mailing Address - Phone:870-925-0074
Mailing Address - Fax:
Practice Address - Street 1:185 CORNERSTONE LN
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6500
Practice Address - Country:US
Practice Address - Phone:501-627-8015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1613224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant