Provider Demographics
NPI:1568540284
Name:SIMPSON, MARY M (OTR/L)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WOODHAVEN WAY
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-9030
Mailing Address - Country:US
Mailing Address - Phone:864-772-1004
Mailing Address - Fax:833-796-6540
Practice Address - Street 1:4122 CLEMSON BLVD STE 4G
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1100
Practice Address - Country:US
Practice Address - Phone:864-772-1004
Practice Address - Fax:833-796-6540
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3173225XH1200X, 225XN1300X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation