Individual
MS. DEEPALI SURYAVANSHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
200 W TYLER AVE, WEST MEMPHIS, AR 72301-4223
(879) 735-1500
Mailing address
1304 EVERGREEN CV, WEST MEMPHIS, AR 72301-1894
(870) 735-2129
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1965
AR
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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