Provider Demographics
NPI:1295841823
Name:MCANALLY, LELA CHRISTINE (OTR L)
Entity Type:Individual
Prefix:MRS
First Name:LELA
Middle Name:CHRISTINE
Last Name:MCANALLY
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 OPPORTUNITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-9185
Mailing Address - Country:US
Mailing Address - Phone:870-942-8335
Mailing Address - Fax:870-942-2234
Practice Address - Street 1:15 OPPORTUNITY DRIVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-9185
Practice Address - Country:US
Practice Address - Phone:870-942-8335
Practice Address - Fax:870-942-2234
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1513225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W308Medicare ID - Type Unspecified