Provider Demographics
NPI:1134510951
Name:MARPLE, KAYLEE
Entity Type:Individual
Prefix:MRS
First Name:KAYLEE
Middle Name:
Last Name:MARPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 121
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:AR
Mailing Address - Zip Code:72311-0121
Mailing Address - Country:US
Mailing Address - Phone:870-821-5292
Mailing Address - Fax:870-633-3304
Practice Address - Street 1:726 NORTH WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335
Practice Address - Country:US
Practice Address - Phone:870-768-5092
Practice Address - Fax:870-633-3304
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT2015-016224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant