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Individual

MARY MARGARET PIERONI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT-A

Contact information

Practice address
316 MAIN ST., LAKE VILLAGE, AR 71653
(870) 265-3950
(870) 265-2525
Mailing address
316 MAIN ST., LAKE VILLAGE, AR 71653
(870) 265-3950
(870) 265-2525

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
OTA331
AR
224Z00000X
Occupational Therapy Assistant
Primary
OTA331
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
138966721
AR
Enumeration date
04/12/2007
Last updated
11/24/2020
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