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General NPI Number Information
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NPI Number | 1447910765
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Entity Type | Individual
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Provider Name | MOLLY LOCKETT
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Gender | Female
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Dates
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Enumeration Date | 12/28/2021
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 1825 E NETTLETON AVE STE D
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City | JONESBORO
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State | AR
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Zip | 72401-5152
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Country | US
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Telephone | 870-520-8761
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Fax |
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Provider Business Mailing Address
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Address Line | 4485 PINE HAVEN CV APT 214
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City | COLLIERVILLE
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State | TN
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Zip | 38017-3954
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Country | US
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Telephone | 573-450-0155
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR4198
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 8545
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License Number State | TN
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