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General NPI Number Information
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NPI Number | 1770649956
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Entity Type | Organization
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Legal Business Name | LEAPS AND BOUNDS PEDIATRIC THERAPY
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3060 DALLAS LOOP
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City | CONWAY
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State | AR
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Zip | 72034-8123
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Country | US
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Telephone | 501-730-0742
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Fax | 501-730-0742
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Provider Business Mailing Address
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Address Line | 3060 DALLAS LOOP
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City | CONWAY
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State | AR
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Zip | 72034-8123
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Country | US
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Telephone | 501-730-0742
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Fax | 501-730-0742
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. LEA ANN ROBINSON
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Credential | OTRL
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Telephone | 501-730-0742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR1281
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License Number State | AR
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