Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brooke Wallace, COTA/L

Individual provider Occupational Therapy Assistant · NPI 1477020659

Brooke Wallace, COTA/L is an Occupational Therapy Assistant in Jonesboro, Arkansas. Licensed in Arkansas. Registered with an NPI since 2018.

Licensed in
AR
In the registry since
2018
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

1699 Red Wolf Blvd
Jonesboro, AR 72401-5442
Phone: (870) 336-0021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence OT-A1418 (AR)

Record details

NPI number1477020659
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA/L
Sole proprietorNo
NPI enumeratedOctober 25, 2018
Last updated in NPPESMay 20, 2021
Certification dateMay 20, 2021
Mailing address313 Natchez Dr, Jonesboro, AR 72404-9104

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