Braci Edmondson, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Fort Smith, AR

NPI 1245824952 · NPPES record last updated Jun 28, 2022

Key facts

NPI
1245824952
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OT-A1600 (AR)
Practice address
5400 Euper LN
Fort Smith, AR 72903
Phone
(479) 755-6601
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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
OT-A1600ARMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Unlimited Learning Academy of Fort Smith Current
since Jul 3, 2022
Accepting new patients
Kids Unlimited Learning Academy of Ft. Smith Past
since Jul 3, 2022
Accepting new patients

Locations

5400 Euper Ln
Fort Smith, AR 72903
Phone (479) 300-6400

3127 Southwest Dr
Ste A
Jonesboro, AR 72404

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X
Occupational Therapy Assistant 224Z00000X OT-A1600 AR Yes

Addresses

Primary practice location

5400 Euper LN
Fort Smith, AR 72903

Mailing address

5400 Euper LN
Fort Smith, AR 72903
Phone (870) 336-8100

Other names

  • Braci Cook Former name

Other providers in Fort Smith, AR

All providers in Fort Smith, AR · Occupational Therapy Assistant in Arkansas

Sources for this page

Verify at the official NPI Registry.