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Individual

LEISHA CALLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
1311 FORT ST, SUITE L, BARLING, AR 72923-2045
(479) 965-5086
(877) 694-8824
Mailing address
201 CEDAR LN, CHARLESTON, AR 72933-9499
(479) 965-5086
(877) 694-8824

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR275
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115954721
AR
01
5S592
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/19/2005
Last updated
10/09/2012
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