Individual
TAYLOR MAE MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
272 SCHOOL AVE, WEST FORK, AR 72774-3124
(479) 839-3349
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1589
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
238537721
—
AR
Enumeration date
02/19/2020
Last updated
01/11/2023
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