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General NPI Number Information
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NPI Number | 1598538514
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Entity Type | Individual
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Provider Name | MORGAN WEAVER GILBERT
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Gender | Female
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 1028 N MISSOURI ST STE 5
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2600
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Country | US
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Telephone | 870-733-5963
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Fax |
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Provider Business Mailing Address
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Address Line | 702 NORMANDY ST
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City | MARKED TREE
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State | AR
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Zip | 72365-2706
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Country | US
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Telephone | 870-514-5127
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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 | OT2023-032
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License Number State | AR
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