Ms. Kera Beth Addison
Occupational Therapist - Pediatrics
1625 S Main St
Malvern
, Arkansas 72104-5600
Ms. Kera Beth Addison
Occupational Therapist - Pediatrics
1625 S Main St
Malvern
, Arkansas 72104-5600
(501) 332-1818
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About
Features
Specialties
- Occupational Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Ms. Kera Beth Addison
- 1625 S Main St
- Malvern, AR
- Zip : 72104-5600
- Phone : (501) 332-1818
Second Address
- Ms. Kera Beth Addison
- 1625 S Main St
- Malvern, AR
- Zip : 72104-5600
- Phone : (501) 332-1818
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Is Ms. Kera Beth Addison a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XP0200X | Occupational Therapist - Pediatrics | OTR2220 | AR |
National Provider Identifier
| NPI | 1063666105 |
|---|---|
| Provider Name | Ms. Kera Beth Addison |
| First Address | Malvern, AR 72104-5600 |
| Second Address | Malvern, AR 72104-5600 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/11/2008 |
| Last Update Date | 24/06/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 175282721 | (05) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.