Provider Demographics
NPI:1184880098
Name:GASKINS, LAURA KIMBERLY (OTA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KIMBERLY
Last Name:GASKINS
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 SARA CIR
Mailing Address - Street 2:
Mailing Address - City:ASH FLAT
Mailing Address - State:AR
Mailing Address - Zip Code:72513-9551
Mailing Address - Country:US
Mailing Address - Phone:870-291-1290
Mailing Address - Fax:
Practice Address - Street 1:703 BIRDIE DR
Practice Address - Street 2:
Practice Address - City:HORSESHOE BEND
Practice Address - State:AR
Practice Address - Zip Code:72512-2864
Practice Address - Country:US
Practice Address - Phone:870-291-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARO-T0814224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant