Individual
LESLIE DIANE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8023 INTERSTATE 30, LITTLE ROCK, AR 72209-4841
(501) 374-0330
(501) 374-0395
Mailing address
1624 N POLK ST, LITTLE ROCK, AR 72207-5328
(501) 786-2800
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR2286
AR
Other
Enumeration date
10/19/2009
Last updated
10/19/2009
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