Provider Demographics
NPI:1760061089
Name:WITHERSPOON, ERIN NICOLE (COTA/L)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:WITHERSPOON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:N
Other - Last Name:MCGEE / HUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 VIOLET CV
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-8758
Mailing Address - Country:US
Mailing Address - Phone:501-858-7562
Mailing Address - Fax:
Practice Address - Street 1:18 VIOLET CV
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-8758
Practice Address - Country:US
Practice Address - Phone:501-858-7562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant