Healthcare Provider Details

I. General information

NPI: 1841115276
Provider Name (Legal Business Name): MARY RENFROE STEVENSON OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 LOWERY PKWY STE 107
FULTONDALE AL
35068-1681
US

IV. Provider business mailing address

2823 GREYSTONE COMMERCIAL BLVD
HOOVER AL
35242-2660
US

V. Phone/Fax

Practice location:
  • Phone: 205-849-6566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7025
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: