Provider Demographics
NPI:1780879882
Name:STELL, DABNEY JANE (COTA)
Entity type:Individual
Prefix:
First Name:DABNEY
Middle Name:JANE
Last Name:STELL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:DABNEY
Other - Middle Name:JANE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTA
Mailing Address - Street 1:111 MEGAN DR.
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655
Mailing Address - Country:US
Mailing Address - Phone:870-308-0049
Mailing Address - Fax:
Practice Address - Street 1:111 MEGAN DR.
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655
Practice Address - Country:US
Practice Address - Phone:870-308-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT0756224Z00000X
ARCOTA502224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant