Individual
MS. MARY THERESE MAYHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
8331 MADISON BLVD STE 300, MADISON, AL 35758-2073
(256) 883-7338
(256) 883-7135
Mailing address
8331 MADISON BLVD STE 300, MADISON, AL 35758-2073
(256) 883-7338
(256) 883-7135
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2306
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125126
—
AL
01
—
51523367
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/13/2007
Last updated
11/27/2024
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