Tammy Creekmore, COTA
Individual provider Active NPI Occupational Therapy Assistant · Dardanelle, AR
NPI 1275912719 · NPPES record last updated May 28, 2015
Key facts
- NPI
- 1275912719
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OT-A946 (AR)
- Practice address
- 12383 Galla Rock Rd
Dardanelle, AR 72834-7478 - Phone
- (479) 477-0179
- NPI assigned
- May 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-A946 | AR | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brave Pediatric Therapy, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OT-A946 | AR | Yes |
Addresses
Primary practice location
12383 Galla Rock Rd
Dardanelle, AR 72834-7478
Mailing address
12383 Galla Rock Rd
Dardanelle, AR 72834-7478
Phone (479) 477-0179
Other providers in Dardanelle, AR
- Stephannie Cawiezell
- Anastasia Desiree Christensen
- Heather Coffman
- Angie Nichole Crane
- Katie Rae Crawford
- Katie E Crow-Goates
- Joshua Craig Cummins
- Stevie Cursh
- Tina Curtis
- Amy Christina Dallas
All providers in Dardanelle, AR · Occupational Therapy Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.