Basic Information
| Provider Information | |||||||||
| NPI: | 1962672162 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCKEE | ||||||||
| FirstName: | OLIVIA | ||||||||
| MiddleName: | MELLICENT | ||||||||
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| Credential: | OTR/L, CLT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4404 GREENWAY DR | ||||||||
| Address2: | |||||||||
| City: | NORTH LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721167408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018125250 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10014 N RODNEY PARHAM RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722275587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012245454 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2008 | ||||||||
| LastUpdateDate: | 11/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OTR1825 | AR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.