Provider Demographics
NPI:1942610498
Name:SPROLES, KARMIN V (OT-A)
Entity Type:Individual
Prefix:
First Name:KARMIN
Middle Name:V
Last Name:SPROLES
Suffix:
Gender:F
Credentials:OT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8018 LEE SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-8325
Mailing Address - Country:US
Mailing Address - Phone:501-563-5656
Mailing Address - Fax:
Practice Address - Street 1:8018 LEE SUMMIT DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-8325
Practice Address - Country:US
Practice Address - Phone:501-563-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A804224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant