Provider Demographics
NPI:1942933791
Name:WALTERS, APRIL LYNN (COTA/L)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:LYNN
Last Name:WALTERS
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 1:403 BEVERLY PL
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-3001
Mailing Address - Country:US
Mailing Address - Phone:501-909-2554
Mailing Address - Fax:
Practice Address - Street 1:121 COX ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-4611
Practice Address - Country:US
Practice Address - Phone:501-776-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1854224Z00000X
224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant