Provider Demographics
NPI:1558953851
Name:HARPER, MACKENNA (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:MACKENNA
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1360
Mailing Address - Country:US
Mailing Address - Phone:740-253-8098
Mailing Address - Fax:
Practice Address - Street 1:734 SHERMAN RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1360
Practice Address - Country:US
Practice Address - Phone:740-253-8098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011384225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist