Provider Demographics
NPI:1386457638
Name:SILVA, DESTINY MICAYLAH (COTA)
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:MICAYLAH
Last Name:SILVA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:DESTINY
Other - Middle Name:MICAYLAH
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:301 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:N LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-2533
Mailing Address - Country:US
Mailing Address - Phone:501-310-2932
Mailing Address - Fax:
Practice Address - Street 1:8109 I 30
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-4840
Practice Address - Country:US
Practice Address - Phone:501-562-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A1785224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant