Provider Demographics
NPI:1144856865
Name:FINNEY, CHRISTIAN BROOKE (COTA/L)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:BROOKE
Last Name:FINNEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 TERRACE
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753-2075
Mailing Address - Country:US
Mailing Address - Phone:870-904-4323
Mailing Address - Fax:
Practice Address - Street 1:1016 N JACKSON
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2448
Practice Address - Country:US
Practice Address - Phone:318-455-4931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1601224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant