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

Mrs. Kelli Wallace, COTA

Individual provider Occupational Therapy Assistant · NPI 1649667353

Mrs. Kelli Wallace, COTA is an Occupational Therapy Assistant in Jacksonville, Arkansas. Licensed in Arkansas. Registered with an NPI since 2015.

Licensed in
AR
In the registry since
2015
What do these letters mean?
COTA — Certified Occupational Therapy Assistant
Delivers treatment under an occupational therapist's direction.

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Practice location Address checks out

2701 T P White Dr
Jacksonville, AR 72076-2514
Phone: (501) 241-0410
Fax: (501) 241-0125
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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-A969 (AR)

Record details

NPI number1649667353
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA
Sole proprietorNo
NPI enumeratedApril 20, 2015
Last updated in NPPESApril 20, 2015

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