Provider Demographics
NPI:1831666106
Name:HAMILTON, KENDRA DANIELLE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:DANIELLE
Last Name:HAMILTON
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 1:3214 WINCHESTER
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-2929
Mailing Address - Country:US
Mailing Address - Phone:501-794-6482
Mailing Address - Fax:501-794-6483
Practice Address - Street 1:3214 WINCHESTER
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-2929
Practice Address - Country:US
Practice Address - Phone:501-794-6482
Practice Address - Fax:501-794-6483
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1419224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant