Provider Demographics
NPI:1043520117
Name:DARBY OT
Entity Type:Organization
Organization Name:DARBY OT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-897-5568
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:LEXA
Mailing Address - State:AR
Mailing Address - Zip Code:72355-0177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:404 2ND ST
Practice Address - Street 2:
Practice Address - City:LEXA
Practice Address - State:AR
Practice Address - Zip Code:72355
Practice Address - Country:US
Practice Address - Phone:870-897-5568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1862225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty