Provider Demographics
NPI:1043344989
Name:MATTHEWS, MARI-GRAY (OTRL)
Entity type:Individual
Prefix:MS
First Name:MARI-GRAY
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:MARI
Other - Middle Name:GRAY
Other - Last Name:SCARBROUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:PO BOX 251418
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1418
Mailing Address - Country:US
Mailing Address - Phone:870-534-0667
Mailing Address - Fax:501-526-6562
Practice Address - Street 1:3450 W 34TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-5508
Practice Address - Country:US
Practice Address - Phone:870-534-7392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112222225XP0200X
AROTR1849225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics