Individual
LATEASHA GAITHER-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
305 N 5TH ST, WEST MEMPHIS, AR 72301-3213
(870) 400-0179
(870) 400-0479
Mailing address
305 N 5TH ST, WEST MEMPHIS, AR 72301-3213
(870) 400-0179
(870) 400-0479
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
113898
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113898
STATE LICENSE
TX
Enumeration date
11/03/2010
Last updated
12/16/2023
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