Provider Demographics
NPI:1962672162
Name:MCKEE, OLIVIA MELLICENT (OTR/L, CLT)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MELLICENT
Last Name:MCKEE
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 GREENWAY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7408
Mailing Address - Country:US
Mailing Address - Phone:501-812-5250
Mailing Address - Fax:
Practice Address - Street 1:10014 N RODNEY PARHAM RD STE 100
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-5587
Practice Address - Country:US
Practice Address - Phone:501-224-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1825225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist