Individual
PROF. KRISTA SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 WILSON LOOP ROAD, WARD, AR 72176
(501) 941-5630
Mailing address
PO BOX 333, WARD, AR 72176-0333
(501) 944-6401
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR711
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U631
BLUE CROSS & BLUE SHIELD
AR
Enumeration date
01/29/2007
Last updated
07/08/2007
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