Provider Demographics
NPI:1588044226
Name:MORRISON, MARY T (OTD R/L)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:T
Last Name:MORRISON
Suffix:
Gender:F
Credentials:OTD R/L
Other - Prefix:DR
Other - First Name:M.
Other - Middle Name:TRACY
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD
Mailing Address - Street 1:4996 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-8086
Mailing Address - Country:US
Mailing Address - Phone:612-300-2039
Mailing Address - Fax:
Practice Address - Street 1:4996 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-8086
Practice Address - Country:US
Practice Address - Phone:612-300-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2798225X00000X, 225XE0001X, 225XN1300X, 225XG0600X, 225XH1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors