Healthcare Provider Details

I. General information

NPI: 1760678064
Provider Name (Legal Business Name): MARY E. GARLINGTON BCBA, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 COLLEGE AVE
CONWAY AR
72034-6141
US

IV. Provider business mailing address

11 EVE LN
CONWAY AR
72034-9379
US

V. Phone/Fax

Practice location:
  • Phone: 501-329-5459
  • Fax:
Mailing address:
  • Phone: 501-329-5459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-16-23106
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: