Healthcare Provider Details

I. General information

NPI: 1770959512
Provider Name (Legal Business Name): HEATHER HORTON MORGAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S UNION ST
DE WITT AR
72042-2727
US

IV. Provider business mailing address

601 S UNION ST
DE WITT AR
72042-2727
US

V. Phone/Fax

Practice location:
  • Phone: 870-946-1606
  • Fax: 870-946-2937
Mailing address:
  • Phone: 870-946-1606
  • Fax: 870-946-2937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: