Abby Layne Clark, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Prescott, AR

NPI 1033937255 · NPPES record last updated Sep 27, 2024

Key facts

NPI
1033937255
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA-2062 (AR)
Practice address
504 E 4TH St N
Prescott, AR 71857-2254
Phone
(870) 887-6674
NPI assigned
Sep 27, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA-2062ARMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PNC, Inc. Past
since Sep 29, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA-2062 AR Yes

Addresses

Primary practice location

504 E 4TH St N
Prescott, AR 71857-2254

Mailing address

306 Lafayette 21
Buckner, AR 71827-9510
Phone (870) 904-3086

Other providers in Prescott, AR

All providers in Prescott, AR · Occupational Therapy Assistant in Arkansas

Sources for this page

Verify at the official NPI Registry.