Healthcare Provider Details

I. General information

NPI: 1285772087
Provider Name (Legal Business Name): MARY S HAMSHER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY S ROGERS OTR/L

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST SLOT 547
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

2017 SAGE MEADOWS CIR
SHERWOOD AR
72120-4373
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-6102
  • Fax:
Mailing address:
  • Phone: 501-231-8078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOTR380
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: