Healthcare Provider Details

I. General information

NPI: 1659779650
Provider Name (Legal Business Name): MARY CLAIRE BOYER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY CLAIRE TUINSTRA OTR/L

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 ELECTRIC AVE
SPRINGDALE AR
72764-7498
US

IV. Provider business mailing address

1103 W COTTONWOOD ST
ROGERS AR
72758-6342
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-1500
  • Fax:
Mailing address:
  • Phone: 831-596-5014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR2782
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: