Individual
ALEXANDRA BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
304 SORENSON ST, NORTH LITTLE ROCK, AR 72118-3473
(501) 246-5191
Mailing address
304 SORENSON ST, NORTH LITTLE ROCK, AR 72118-3473
(501) 246-5191
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1912
AR
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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