Provider Demographics
NPI:1023314267
Name:BAUGH, ERICA LEIGH ANN (COTA/L)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LEIGH ANN
Last Name:BAUGH
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 1:4313 LOCHMOOR CIR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-8146
Mailing Address - Country:US
Mailing Address - Phone:870-373-0941
Mailing Address - Fax:
Practice Address - Street 1:661 COUNTY ROAD 754
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72405-8256
Practice Address - Country:US
Practice Address - Phone:870-373-0941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-06
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTA559224Z00000X
224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant