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General NPI Number Information
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NPI Number | 1811269988
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Entity Type | Individual
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Provider Name | DIANA L MCANALLY OTR1541
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Gender | Female
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 401 SOUTHRIDGE PARKWAY
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-8853
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Country | US
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Telephone | 501-804-2304
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Fax | 501-851-1137
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Provider Business Mailing Address
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Address Line | P.O. BOX 13525
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City | MAUMELLE
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State | AR
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Zip | 72113-0525
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Country | US
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Telephone | 501-804-2304
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Fax | 501-851-1137
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OTR1541
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License Number State | AR
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