Provider Demographics
NPI:1588258719
Name:MASSERY, MARY E (OT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:MASSERY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 LOWER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-8510
Mailing Address - Country:US
Mailing Address - Phone:501-428-5126
Mailing Address - Fax:
Practice Address - Street 1:300 PLEASANT VALLEY DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-3158
Practice Address - Country:US
Practice Address - Phone:501-447-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-28
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist