Provider Demographics
NPI:1457509135
Name:GRIFFIN, DORATHY JANE (MS,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DORATHY
Middle Name:JANE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:FORDYCE
Mailing Address - State:AR
Mailing Address - Zip Code:71742-2809
Mailing Address - Country:US
Mailing Address - Phone:870-352-7185
Mailing Address - Fax:
Practice Address - Street 1:2410 PINE ST
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4335
Practice Address - Country:US
Practice Address - Phone:870-245-2210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2198225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist