Provider Demographics
NPI:1649794538
Name:SMITH, BRITTANY LEIGH (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:LEIGH
Last Name:SMITH
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:LEIGH
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 FOXFIRE CV
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-2610
Mailing Address - Country:US
Mailing Address - Phone:501-388-0340
Mailing Address - Fax:
Practice Address - Street 1:206 PLAZA BLVD STE F
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3748
Practice Address - Country:US
Practice Address - Phone:501-286-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1249224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant