Individual
LANEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4818 AR-5, BRYANT, AR 72022
(870) 484-2555
Mailing address
1903 N ROCK ST, SHERIDAN, AR 72150-7759
(870) 484-2555
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1655
AR
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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