Individual
LEEANNA TANKERSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8607 HIGHWAY 16 E, SHIRLEY, AR 72153-8265
(501) 454-6642
Mailing address
189 N MAIN ST, SHIRLEY, AR 72153-7539
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A719
AR
Other
Enumeration date
09/05/2012
Last updated
12/22/2023
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