Provider Demographics
NPI:1114227337
Name:HENRY, MORGAN HOPKINS (OT)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:HOPKINS
Last Name:HENRY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 FOUR WINDS DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-7789
Mailing Address - Country:US
Mailing Address - Phone:501-733-6967
Mailing Address - Fax:
Practice Address - Street 1:235 FOUR WINDS DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-7789
Practice Address - Country:US
Practice Address - Phone:501-733-6967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2364225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics