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Contact Information

JILL J BROYLES, COTA
23 PARKCLIFF DR
HOLIDAY ISLAND, AR72631-8045
 Phone: 479-363-6422
 Fax: 479-363-6763
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
 

Nursing Home Administrator

376G00000X
Indicates primary specialty

NPI Profile & details for JILL J BROYLES · (Female)

NPI Number 1902144058
Status Active
Credentials COTA (Certified Occupational Therapy Assistant)
Entity Individual
Enumeration date 01/24/2013
Last updated 03/24/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • AR License # OT-A1905
  • KS License # 1800833
  • KS License # 3786
  • MO License # 2021006128
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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