MEDICARE: MS. MARIA CRISTINA KING MS, OTRL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OTR2067	AR

General Provider Information

NPI Number	:	1174721682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA CRISTINA KING MS, OTRL

Provider Business Mailing Address
First Line	:	8618 BUCK RD
Second Line	:
City	:	ALEXANDER
State	:	AR
Zip	:	72002-7416
Country	:	US
Telephone Number	:	501-208-3022
Fax Number	:

Provider Business Practice Location Address
First Line	:	17706 I 30 STE 3
Second Line	:
City	:	BENTON
State	:	AR
Zip	:	72019-2930
Country	:	US
Telephone Number	:	501-315-4414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	10/25/2023

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