Provider Demographics
NPI:1952290033
Name:AUSTIN, DENISE MAYREE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:MAYREE
Last Name:AUSTIN
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 1:813 MILLER COUNTY 7
Mailing Address - Street 2:
Mailing Address - City:FOUKE
Mailing Address - State:AR
Mailing Address - Zip Code:71837-8682
Mailing Address - Country:US
Mailing Address - Phone:903-278-7577
Mailing Address - Fax:
Practice Address - Street 1:1417 ROLLING RIDGE CIR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-9036
Practice Address - Country:US
Practice Address - Phone:903-276-6012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A2132224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant