Provider Demographics
NPI:1184945313
Name:LANSDALE, KARI BAKER (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:KARI
Middle Name:BAKER
Last Name:LANSDALE
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 1:2161 LEE ROAD 925
Mailing Address - Street 2:
Mailing Address - City:MORO
Mailing Address - State:AR
Mailing Address - Zip Code:72368-9333
Mailing Address - Country:US
Mailing Address - Phone:870-821-9576
Mailing Address - Fax:
Practice Address - Street 1:2161 LEE ROAD 925
Practice Address - Street 2:
Practice Address - City:MORO
Practice Address - State:AR
Practice Address - Zip Code:72368-9333
Practice Address - Country:US
Practice Address - Phone:870-821-9576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant