Individual
SHUNTRAIL LESHA IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BT
Contact information
Practice address
1540 COUNTRY CLUB RD, SHERWOOD, AR 72120-5095
(501) 753-5459
(501) 753-5463
Mailing address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
(501) 327-1738
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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