Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OTR380 | AR |
NPI | 1285772087 |
---|---|
Provider Name | Mrs. Mary S Hamsher |
First Address | Sherwood, AR 72120-4373 |
Second Address | Little Rock, AR 72205-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 21/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OTR380 | STATE MEDICAL LICENCE NUMBER OTR380 (01) | AR |