Individual
MRS. ALEISHA MARIE MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
6917 GEYER SPRINGS ROAD, SUITE 1 S, LITTLE ROCK, AR 72209
(501) 570-4004
(501) 570-4003
Mailing address
PO BOX 13507, MAUMELLE, AR 72113
(501) 570-4004
(501) 570-4003
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1775
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X015
BLUE CROSS BLUE SHIELD
AR
Enumeration date
08/12/2006
Last updated
07/08/2007
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