Provider Demographics
NPI:1285772087
Name:HAMSHER, MARY S (OTR)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:S
Last Name:HAMSHER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:S
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2017 SAGE MEADOWS CIR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-4373
Mailing Address - Country:US
Mailing Address - Phone:501-231-8078
Mailing Address - Fax:
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:SLOT 547
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR380225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AROTR380OtherSTATE MEDICAL LICENCE NUMBER OTR380