Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0200X | Occupational Therapist - Pediatrics | 112222 | TX |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OTR1849 | AR |
NPI | 1043344989 |
---|---|
Provider Name | Ms. Mari Gray Scarbrough |
First Address | White Hall, AR 71602-4778 |
Second Address | Pine Bluff, AR 71603-5508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 20/01/2010 |