Provider Demographics
NPI:1710560289
Name:OLIVER, DEBRA JUNE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JUNE
Last Name:OLIVER
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 1:410 GREENWOOD
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-8901
Mailing Address - Country:US
Mailing Address - Phone:479-228-3841
Mailing Address - Fax:479-524-8079
Practice Address - Street 1:410 GREENWOOD
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-8901
Practice Address - Country:US
Practice Address - Phone:479-228-3841
Practice Address - Fax:479-524-8079
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1719224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant