Healthcare Provider Details

I. General information

NPI: 1215831540
Provider Name (Legal Business Name): EMILY RAEGEN MAGBY OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 CARSON ST
HOT SPRINGS AR
71901-6852
US

IV. Provider business mailing address

121 PARKWAY SQ
PEARCY AR
71964-9712
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-6468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTR4286
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: