Provider Demographics
NPI:1164756482
Name:REED, DARCIE RENEE (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DARCIE
Middle Name:RENEE
Last Name:REED
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MISS
Other - First Name:DARCIE
Other - Middle Name:RENEE
Other - Last Name:MOWERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72654
Mailing Address - Country:US
Mailing Address - Phone:870-213-6545
Mailing Address - Fax:870-580-0636
Practice Address - Street 1:100 E. 9TH STREET
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653
Practice Address - Country:US
Practice Address - Phone:870-213-6545
Practice Address - Fax:870-424-3208
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2281225XP0200X, 225X00000X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR179549721Medicaid