Healthcare Provider Details

I. General information

NPI: 1851157267
Provider Name (Legal Business Name): ANNA CRENSHAW OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N WALTON BLVD STE 2AND4
BENTONVILLE AR
72712-4548
US

IV. Provider business mailing address

3705 SW GREY HAWK DR
BENTONVILLE AR
72713-8437
US

V. Phone/Fax

Practice location:
  • Phone: 479-250-9838
  • Fax:
Mailing address:
  • Phone: 479-871-3387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR3818
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: