Individual
LORI TANKERSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1500 WILSON LOOP, WARD, AR 72176
(501) 588-3211
(501) 353-2599
Mailing address
28 JERRELL RD, MAYFLOWER, AR 72106-9646
(501) 941-5630
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1881
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154489721
—
AR
01
—
5X731
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/12/2006
Last updated
11/14/2016
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