Cooper, Tabitha Dawn

Cooper, Tabitha Dawn is an sole proprietor health care provider with primary practice located at 1601 Greenhouse Rd , Bentonville AR 72713-9292. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Cooper, Tabitha Dawn can be contacted via phone (479) 795-1260.

Contact Information

Primary practice address
1601 Greenhouse Rd Bentonville AR 72713-9292
Phone: (479) 795-1260
Fax: (479) 795-1261
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 1455OTR Arkansas

Profile Details

NPI number 1023068947
LBN Legal business name Cooper, Tabitha Dawn
Credentials OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2006
Last updated Oct 1st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023068947 NPPES
Arkansas MEDICAID 137338721
Arkansas Other 5U652

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