Individual
MARY WALT DERRYBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
409 OAK STREET, MCGEHEE, AR 71654
(870) 222-5400
Mailing address
205 S COLLEGE ST, DUMAS, AR 71639-2212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR692
AR
Other
Enumeration date
05/07/2007
Last updated
07/09/2007
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