Healthcare Provider Details
I. General information
NPI: 1578480430
Provider Name (Legal Business Name): BODY & SOUL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1105 SHIPLEY ST
SPRINGDALE AR
72764-5453
US
IV. Provider business mailing address
1105 SHIPLEY ST
SPRINGDALE AR
72764-5453
US
V. Phone/Fax
- Phone: 479-381-4866
- Fax:
- Phone: 479-381-4866
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SHARA
MANNING
Title or Position: OCCUPATIONAL THERAPIST/ OWNER
Credential: OTR/L, C-HYI
Phone: 479-381-4866