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Individual

SHEENA MARIE LEAVELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
1301 RUSSELL RD, RUSSELLVILLE, AR 72802-4320
(479) 967-2322
Mailing address
227 PLESS COMMUNITY RD, LONDON, AR 72847-8612
(479) 967-2322

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2280
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
194789721
AR
Enumeration date
01/15/2013
Last updated
01/15/2013
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