Healthcare Provider Details

I. General information

NPI: 1699064071
Provider Name (Legal Business Name): EMILY R VERNON MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3103 S 28TH ST
FORT SMITH AR
72901-6901
US

IV. Provider business mailing address

3103 S 28TH ST
FORT SMITH AR
72901-6901
US

V. Phone/Fax

Practice location:
  • Phone: 479-388-0826
  • Fax:
Mailing address:
  • Phone: 918-346-0337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: