Provider Demographics
NPI:1801631486
Name:SHIRLEY, ALLISON CLAIRE (OTD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:CLAIRE
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:CLAIRE
Other - Last Name:HOUSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD
Mailing Address - Street 1:5650 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-8330
Mailing Address - Country:US
Mailing Address - Phone:870-799-9559
Mailing Address - Fax:
Practice Address - Street 1:5650 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-8330
Practice Address - Country:US
Practice Address - Phone:870-799-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3945225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist